Biological Therapies For Schizophrenia

Question 1

Drug treatments

Answer 1

Conventional eg chlorpromazine - used primarily to combat positive symptoms - dopamine antagonists so they bind to receptors but don’t stimulate then blocking their action
- by reducing stimulation, antipsychotics can alleviate hallucinations/delusions

Atypical - eg clozapine - block serotonin receptors, temporarily occupying Dz receptors than rapidly dissociating to allow normal dopamine transmission

Question 2

Effectiveness and appropriateness of conventional

Answer 2

Effectiveness -

• Davis et al - found sig diff in terms of relapse rates between treatment and placebo groups in every study received
• Vaughn and Leff - antipsychotics did have sig effect but only with those facing hostility and criticism in their homes
• Kane - 80-85% effective

Appropriateness -

• tardive dyskensia - 30% taking antipsychotics develop it - irreversible in 75% of cases
• Ross and Read - prevents individual from considering unique stressors that may be a trigger

Question 3

Effectiveness and appropriateness of atypical -

Answer 3

Effectiveness - Leucht - metanalysis revealed superiority of atypical to conventional only moderate

• the claim atypical antipsychotics are particularly effective has marginal support
• clozapine - 60-70% effective

Appropriateness - lower likelihood of tardive dyskensia - Jeste found 30% conventional rates but 5% atypical
- fewer side effects

Deals with symptoms not cause

Question 4

Electro convulsive therapy

Answer 4

Therapist administers electric shock to one side or hemisphere of the persons brain via electrodes attached at the temples

• forces patient to experience a seizure that lasts 1/2 a second with a strength of 800 miliamps
• approx 6 treatments, 2/3x a week

Question 5

Appropriateness and effectiveness of ECT

Answer 5

Appropriateness - can result in STM loss

• 1/3 report it as distressing
• no convincing evidence it works - unscientific to use a method barely understood
• ethical concerns - informed consent not always present, may do harm

Effectiveness - 50-70% of patients benefit initially but then further treatment is required

• in comparison of ECT and placebos ECT did have some effect but only on those who suffered delusions
• useful as a last resort