biological treatment for schizophrenia

Question 1

define the first generation antipsychotics (FGAs)

Answer 1

these are antagonists for dopamine activity within 48 hours, it can take several weeks to reduce the symptoms of schizophrenia

Question 2

explain the effectiveness of first-generation antipsychotics

Answer 2

• the most effective first generation anti-psychotics are the oens who bind to the D2 receptor
• dopamine hypothesis states that schizophrenia is caused by hyperdopaminergia in the mesolimbic pathway and hypodopaminergia in the mesocrotical pathway
• being able to treat schizophrenia with a pill brought a huge change in mental health care - decreasing the uses of electroshock therapy, lobotomies

Question 3

explain the side effects of first generation anti-psychotics

Answer 3

• side effects of first generation antipsychotics: dryness of mouth, weight gain, sleep problems, muscle spams and drooling
• these side effects made it difficult to keep patients on their medication once released from hospital
• Barlow and Durand found that these cannot relieve all negative symptoms of schizophrenia, 40% gain no relief

Question 4

define second generation anti-psychotics

Answer 4

• newer anti-psychotics that cause fewer side effects
• examples: clozapine, olanzapine

Question 5

describe clozapine as a second generation anti-psychotic

Answer 5

• clozapine acts as an antagonist for dopamine but also acts on the receptors of seratonin and glutamate, which reduces both positive and negative symptoms
• one side effect is the potneitally fatal blood condition which has led to this drug falling out of favour thought it is still used with treatment resistant clients, providing relief for up to 60% of people
• clients have regular blood tests to avoid the disease

Question 6

describe protocol of anti-psychotics

Answer 6

• Patel reviewed the efficacy of medication for schizophrenia, and explains that it is important to start medication quickly in order to be the most effective
• in the first 7 days following a psychotic episode the objective is to decrease hostility and to attempt to return the client to normal functioning
• once the symptoms start to subside a maintenance dose would then be prescribed to encourage socialisation, and self-care for 12 months to prevent relapse

Question 7

what is the advantage of the biological treatment of schizophrenia

Answer 7

• there is large meta-analysis which provides good empirical evidence
• Zhao conduced a meta-analysis comparing 18 antipsychotics and utilising data from 56 randomised control trials with over 10,000 people
• 17 of the antipsychotics tested had significantly lower relapse rates than the placebos
• drug treatments could be helpful, allowing people with schizophrenia to avoid the emotional and financial costs of hospital treatments which may be the only alternative if medication fails

Question 8

what is the disadvantage of the biological treatment of schizophrenia

Answer 8

• much research on drug treatments of schizophrenia is conducted on animals so it is not generalisable to humans
• Kapur cautions against overgeneralising from animal studies
• high doses of medication can be given to animals so that the D2 receptors can be effectively blocked out, but doing this would lead to severe side effects in humans
• such research may demonstrate symptoms are reduced but animal models cannot show how much side effects would interfere with everyday life or whether this would lead to lack of compliance
• laboratory research cannot always replicate the lived experience of taking daily medication and coping with incapacitating side effects, which can be a major barrier to treatment

Question 9

what is the application of the biological treatment of schizophrenia

Answer 9

• in previous decades people with schizophrenia would have had little choice but to spend their lives in institutional care
• the advent of anti-psychotic drugs in the 1950s meant an enormous change in the way people with schizophrenia could live their lives
• once a person was placed in a mental hospital they became institutionalised and unable to cope on their own
• anti-psychotic drugs meant that people with a diagnosis of schizophrenia had a chance to remain in the community
• this is important because the segregation of people with mental health problems into long-stay hospitals further increases the stigmatisation through lack of contact with the rest of the community