Biological Therapies

Question 1

Conventional antipsychotic drugs (e.g chlorpromazine)

Answer 1

dopamine antagonists, bind to D2 receptors, block action
reduce stimulation of dopamine system, eliminate positive symptoms
effectiveness led to dopamine hypothesis

Question 2

Atypical antipsychotic drugs

Answer 2

block serotonin, temporarily occupy D2
dissociate, allow normal dopamine transmission
lower level of side effects

Question 3

Electroconvulsive therapy (ECT)

Answer 3

injected with barbiturate, unconscious
given nerve-blocking agent, paralyse muscles
0.6 amps electric current, 1 min. seizure
3-15 treatments

Question 4

Davis et al (1980)

Answer 4

55% relapse of placebo

19% in those who remained on drugs

Question 5

Other factors - environment

Answer 5

Vaughn and Leff (1976): medication made diff. for those with hostility and criticism in home
Relapse on medication 55%, placebo 92%
Supportive home, no sig. diff.

Question 6

Conventional antipsychotic - tardive dyskinesia

Answer 6

30% develop, irreversible in 75%

Question 7

Motivational deficits

Answer 7

Ross and Read (2004): medication reinforces there is something wrong
prevents individual thinking about possible stressors that trigger SZ

Question 8

Atypical vs. conventional

Answer 8

meta-analysis, superiority of atypical only moderate

Question 9

Effectiveness of atypical antipsychotics

Answer 9

only marginal support for effectiveness with negative symptoms

Question 10

Atypical - lower likelihood of tardive dyskinesia

Answer 10

Jeste et al (1999): 30% of people after 9m treatment with conventional
5% those treated with atypical

Question 11

Atypical - fewer side effects so

Answer 11

more likely to continue medication, more benefits

Question 12

Effectiveness of ECT - APA

Answer 12

American Psychiatric Association review (2001) listed 19 studies comparing ECT and stimulated
results no diff. to medication

Question 13

Effectiveness of ECT - Indian study

Answer 13

no diff. in symptom reduction between 36 SZ patients given stimulated/ ECT

Question 14

Appropriateness of ECT - risks

Answer 14

include memory dysfunction, brain damage

led to declined use

Question 15

Appropriateness of ECT - Tharyan and Adams (2005)

Answer 15

reviewed 26 studies, ECT more effective than sham
long/medium term advantage?
evidence suggest ECT + drugs - greater improvement in mental state, may be required if patients show little response

Question 16

Ethical issues

Answer 16

side effects, deaths, psychological consequences

cost-benefit analysis of advantages would be negative

Question 17

Are placebo studies a fair test?

Answer 17

Ross and Read (2004): placebo condition - patient in withdrawal state, blocked dopamine sys. flooded with DA due to heightened sensitivity and increased receptors - overwhelmed
placebo responses explained by withdrawal effects