Biological treatment of schizophrenia

Question 1

What are anti-psychotics ?

Answer 1

• main type of drug used to treat schizophrenia
• They reduce the intensity of positive symptoms

Question 2

What are the two different types of anti-psychotics ?

Answer 2

• Typical
• Atypical

Question 3

What are typical anti-psychotics ?

Answer 3

• traditional drugs
• e.g. Chlorpromaxine

Question 4

What are atypical anti-psychotics ?

Answer 4

• modern drugs
• Clozapine
• Risperidone

Question 5

How can antipsychotics be administered ?

Answer 5

• tablets
• syrup
• injections (every 2-4 weeks)

Question 6

What does chlorpromazine do ?

Answer 6

• works as an antagonist
• decreases the levels of dopamine therefore works on the hyperdopamingeria hypothesis

Question 7

How does chlorpromazine work ?

Answer 7

• Blocks dopamine receptors sites in the synapse by binding to them on the post-synaptic neuron
• Initially dopamine is increased before the production is decreased
• This reduces the positive symptoms of schizophrenia
• This also acts as a sedative

Question 8

What is a strength of chlorpromazine ?

Answer 8

• Helps calm a patient down which means healthcare staff can provide appropriate care

Question 9

What is a limitation of chlorpromazine ?

Answer 9

• Acts as a restraint which makes it harder for those taking it to function in real-life situation
• This supports the chemical cosh argument which is when the drug benefits the carers more than the patients

Question 10

What are the side effects of chlorpromazine ?

Answer 10

Mild effects = weight gain, dizziness

Prolonged effects = tardive dyskinesia - uncontrollable movements

Severe effects = 0.1-2% of patients - neuroleptic malignal syndrome - can lead to a coma or death

Question 11

What is clozapine ?

Answer 11

• atypical drug
• binds to dopamine receptors as well as serotonin and glutamate receptors in the synapse
• this drug improves mood
• helps reduce the comorbidity of depression and anxiety as well as improving cognitive function
• have to have frequent blood tests to monitor potential blood disorder

Question 12

What are the positive of clozapine ?

Answer 12

• monitored for potential side effects (can catch them early to prevent severe side effects)
• appropriate for those with co-morbidity - helps with suicide rates as those with multiple disorders are more likely to commit
• helps both positive and negative symptoms

Question 13

What is risperidone ?

Answer 13

• binds to dopamine and serotonin receptors in the synapse
• binds more strongly to receptors sites which means smaller doses can be administered
• evidence suggests that there are smaller and fewer side effects

Question 14

What are the strengths of risperidone ?

Answer 14

• helps with co-morbidity
• doesn’t affect someones life quality
• helps with both positive and negative symptoms

Question 15

What are the strengths of the biological treatment of schizophrenia ?

Answer 15

Effectiveness =
- Meltzer
- Said that clozapine is more effective than typical and other anti-psychotics
- 30-50% of patients who didn’t work with typical psychotics worked with clozapine

Practicalities =
- anti-psychotics don’t take long to administer
- a tablet only takes a short time to take
- means that it is easy to remember and don’t take hours/days

Question 16

What are the limitations of the biological treatment of schizophrenia ?

Answer 16

Effectiveness =
- bad side effects
- by having side effects that prevent patients from continuing with daily life it stops them from continuing the course of treatment
- the drug isn’t effective if it isn’t taken

Suitability =
- Chlorpromazine
- only treats positive symptoms
- not suitable for those who show both positive and negative symptoms such as avolition

Conflicting research against effectiveness =
- Healy
- Suggested that most effectiveness studies only show short term effects
- just because symptoms have been calmed doesn’t mean that psychosis has been reduced

Ethics =
- Chemical Cosh argument
- more beneficial to health-care professionals than the patients
- works as an invisible restraint for them to make their jobs easier