Therapy for schizophrenia
Drug therapy.
First generation Antipsychotics are called “Typical Antipsychotics” Eg. Chlorpromazine and Haloperidol.
Typical antipsychotic drugs are used to reduce the intensity of positive symptoms, blocking dopamine receptors in the synapses of the brain and thus reducing the action of dopamine.
They arrest dopamine production by blocking the D2 receptors in synapses that absorb dopamine, in the mesolimbic pathway thus reducing positive symptoms, such as auditory hallucinations.
But they tended to block ALL types of dopamine activity, (in other parts of the brain as well) and this caused side effects and may have been harmful.
Newer drugs, called “atypical antipsychotics” attempt to target D2 dopamine activity in the limbic system but not D3 receptors in other parts of the brain.
Atypical antipsychotics such as Clozapine bind to dopamine, serotonin and glutamate receptors.
Atypical antipsychotic drugs work on negative symptoms, improving mood, cognitive functions and reducing depression and anxiety.
They also have some effect on other neurotransmitters such as serotonin. They generally have fewer side effects eg. less effect on movement Eg. Clozapine, Olazapine and Risperidone.
Since the mid-1950s antipsychotic medications have greatly improved treatment. Medications reduce positive symptoms particularly hallucinations and delusions; and usually allow the patient to function more effectively and appropriately.
Antipsychotic drugs are highly effective as they are relatively cheap to produce, easy to administer and have a positive effect on many sufferers. However they do not "cure" schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community.
Kahn et al. (2008) found that antipsychotics are generally effective for at least one year, but second- generation drugs were no more effective than first-generation ones.
Some sufferers only take a course of antipsychotics once, while others have to take a regular dose in order to prevent symptoms reappearing. There is a sizeable minority who do not respond to drug treatment. Pills are not as helpful with other symptoms, especially emotional problems. Older antipsychotics like haloperidol or chlorpromazine may produce side effects Sometimes when people with schizophrenia become depressed, so it is common to prescribe anti-depressants at the same time as the anti-psychotics.
All patients are in danger of relapsing but without medication the relapses are more common and more severe which suggests the drugs are effective.
Clozapine targets multiple neurotransmitters, not just dopamine, and has been shown to be more effective than other antipsychotics, although the possibility of severe side effects – in particular, loss of the white blood cells that fight infection Even newer antipsychotic drugs, such as risperidone and olanzapine are safer, and they also may be better tolerated. They may or may not treat the illness as well as clozapine, however.
Meta–Analysis by Crossley Et Al (2010) suggested that Atypical antipsychotics are no more effective, but do have less side effects.
Recovery may be due to psychological factors – The placebo effect is when patients’ symptoms are reduced because they believe that it should – However, Thornley et al carried out a meta-analysis comparing the effects of Chlorpromazine to placebo conditions and found Chlorpromazine to be associated with better overall functioning – Drug therapy is an effective treatment for SZ.
RWA – Offering drugs can lead to an enhanced quality of life as patients are given independence – Positive impact on the economy as patients can return to work and no longer need to be provided with institutional care.
Ethical issues – Antipsychotics have been used in hospitals to calm patients and make them easier for staff to work with rather than for the patients’ benefit – Can lead to the abuse of the Human Rights Act (no one should be subject to degrading treatment).
Severe side effects – Long term use can result in tardive dyskinesia which manifests as involuntary facial movements such as blinking and lip smacking – While they may be effective, the severity of the side effects mean the costs outweigh the benefits therefore they are not an appropriate treatment.
Explain one way that drug therapy will help Noah with his symptoms of schizophrenia. (2)
Explain two strengths of using secondary data to research the effectiveness of drug treatments for individuals with schizophrenia. (4) October 2018
Describe one similarity and one difference between RCTs and interviews when used to research drug treatments for schizophrenia. (4) October 2018
Explain three weaknesses of using drug therapy as a treatment for schizophrenia. (6) June 2017
Explain two ways that drug therapy could help Craig as a treatment for his schizophrenia. (6) January 2019
Evaluate the effectiveness of drug and family therapies in the treatment of schizophrenia. (16) January 2018
Evaluate drug therapy as a treatment for schizophrenia. (16) June 2019