Biological Treatments

Question 1

Antipsychotics

Answer 1

Antipsychotics are dopamine antagonists because they bind to complementary dopamine receptors on the postsynaptic membrane, thus preventing dopamine molecules from binding to these sites.
The result is an inhibitory effect, where there is a lower rate of action potential generation in the postsynaptic membranes, and so returns neurotransmission to a normal level.

Question 2

Typical antipsychotics

Answer 2

Described as ‘first generation’ because these were the drugs historically prescribed to treat SZ patients.

Question 3

Atypical antipsychotics

Answer 3

Atypical antipsychotics are described as ‘second generation’ because they were developed to add to the effectiveness of first generation medications, and also alleviate the serious side effects associated with such drugs. Atypical antipsychotics work in the same way as typical antipsychotics, but also target other neurotransmitter receptors on postsynaptic membranes, in line with more modern research.

Question 4

Clozapine

Answer 4

Targets serotonin and glutamate receptors. Improves cognitive functioning and mood.

Question 5

Risperidone

Answer 5

Acts on dopamine and serotonin receptors. Smaller doses are required because it
acts more strongly on dopamine receptors compared to Clozapine, and so would be particularly suited to patients who do not suffer from depression but have a previous history of blood-related illnesses.

Question 6

• P - Based on the dopamine hypothesis, so their use depends on this too

Answer 6

E - If antipsychotics appear to alleviate symptoms by reducing the action of dopamine, this makes sense considering the original dopamine hypothesis i.e. hyperdopaminergia in the subcortex.
E - However, this action is not in line with the revised version of the dopamine hypothesis, which suggests that abnormally low levels of dopamine in the cortex are responsible for symptoms. Therefore, a further reduction in dopamine levels should make symptoms
worse, and not better.
L - This paradox has caused some to question the validity of the use of antipsychotics, as well as the accuracy of the dopamine hypothesis as an explanation for schizophrenia.

Question 7

• P - Side effects

Answer 7

E - There are short term side effects (agitation and weight gain) and long time side effects (involuntary contraction and relaxation of the facial muscles).
E - These side effects are not offset by atypical antipsychotics, where agranulocyotis remains a serious concern for those taking Clozapine, whose state must be continually monitored using blood tests.
L - Therefore, a cost-benefit analysis should be carried out to consider whether the benefit of symptom reduction outweighs the cost of side effects for each specific patient.