A2 SCHIZOPHRENIA - BIOLOGICAL TREATMENTS

Question 1

Describe typical antipsychotics

Answer 1

An older type of antipsychotic; dev.ed in the 50s, e.g. chlorpromazine (taken orally as tablet or syrup, up to 1000mg per day). Injection can be used if effects are needed more quickly. Not used very frequently today

Blocks dopmaine receptor sites therefore decresing levels of dopamine in the brain (based on old view of hyperdopaminergia). Hyperd. leads to +ve symptoms e.g. hallucinations, so typical antipsychotics reduce +ve symptoms

Can also be used as a general sedative not just for sch patients, but any patient, especially when they arrive in hospital very anxious

Question 2

Describe atypical antpsychotics

Answer 2

Newer type of antipsychotic; dev.ed in the 70s in order to increase effectveness of symptom reduction of typical antipsychotics and also reduce the side effects

e.g. clozapine:
=> w/drawn from market after developmet in 60s and release in 70s, due to causing a potentially fatal blood condition in some patients, but reintroduced in late 80s due to high effectiveness compared to typical drugs.
=> taken orally 300-400mg per day
=> binds to dopamine, serotonin and glutamate receptor sites and so treats both +ve and -ve symptoms as well as depression and anxiety in patients (especially when patient is considered at high risk of suicide)

e.g. risperidone:
=> dev.ed in 90s to try and be as effective as clozapine but w/out the side effects
=> oral dosage of just 4-8mg per day (max of 12mg); low dosage as it binds to dopmaine and serotonin receptor sites much stronger, and low dosage reduces side effects

Question 3

Evaluate typical antipsychotics

Answer 3

(-) Side effects; tardive dyskinesia (uncontrollable face and mouth movements) and Parkinson’s-like symptoms i.e. “the shakes”
(-) Many patients believe they’re being poisoned due to delusions so won’t accept drug treatment
(+) Thornley (2003) found chlorpromazine to be sig more effective than a placebo
(-) Unethical to just give sch a placebo i.e. no other help whilst others are receiving help; placebo grous often receive CBT or other therapy which then acts as an extraneous variable

Question 4

Evaluate atypical antipsychotics

Answer 4

(-) Clozapine has a potentially fatal blood condition associated with it; patients must be carefully monitored and have regular ECGs
(-) Blood condition association means it’s unsuitable for a lot of ppl who have existing heart/blood conditions e.g. obesity
(-) Meltzer (2012) found clozapine works for 30-50% of patients who don’t respond to chlorpromazine
(+) Risperidone is highly effective and has small dosages so reduced side effects

Question 5

Evaluate drug therapy in general

Answer 5

(+) Recent development of a tracable antipsychotic drug allows doctors to know if patients have actually taken their mediaction
(-) Drugs cost up to £210 million to the UK economy per year
(+) However this is often cheaper than hospitalistion
(-) Patients must take drugs over years and years; tolerances build up so dosages must increase so side effects become more severe