biological treatments for schizophrenia

Question 1

drug therapies/treatments

Answer 1

• most common treatment=antipsychotic drugs
• usually daily in tablets. for those not at risk of taking their medication (non-compliance/non-adherence) injections can be given every 2-4 weeks
• antipsychotics can be used short term or long term

Question 2

typical antipsychotics

Answer 2

• developed in 1950s
• chloropromazine: can be taken as pills, syrup or injections
• chloropromazine is antagonist in the dopamine system
• it blocks dopamine receptors in the synapse of the brain, reducing the action of dompamine.

Question 3

how does chloropromazine work

Answer 3

it blocks the action of the neurotransmitter dopamine in the brain by binding to, but not stimulating dopamine receptors

Question 4

side effects of chloropromazine

Answer 4

• has a sedation effect: it affects the histamine receptors which leads to drowsiness
• weight gain
• sexual disorder
• blurred vision

Question 5

atypical antipsychotics

Answer 5

• developed in the 1970s
• showed improved effectiveness in suppressing psychoses such as schizophrenia and minimised the side effects
• typically target a range of neurotransmitters including dopamine and serotonin
• although they are often effective, it’s not known exactly how or why they work

Question 6

clozapine

Answer 6

• binds to dopamine receptors as chloropromazine does, but also acts on serotonin and glutamate receptors
• more effective than typical antipsychotics: reduces depression and anxiety (30-50% of people suffering schizophrenia attempt suicide) as well as improving cognitive functioning

Question 7

why was clozapine withdrawn

Answer 7

• clozapine was withdrawn in the 1970s following the death of some patients from a condition called agranulocytosis
• agranulocytosis: an actute condition involving a very severe and lowered white blood cell count.
  people with this condition are at very high risk of serious infections due to their suppressed immune system

Question 8

risperidone

Answer 8

• developed in the 1980s
• like clozapine, it bind to dopamine and serotonin receptors as an antagonist, down-regulating their effect
• however it binds more strongly to the dopamine receptors and therefore is more effective in smaller doses than most anti psychotics - it also has fewer side effects

Question 9

evaluation: side effects

Answer 9

p: side effects
e: typical anti-psychotics are associated with dizziness, sleepiness, weight gain, stiff jaw etc
c: atypical antipsychotics were developed to reduce side effects but still have many and this is a major limitation of drug therapies - reason why about 50% of sufferers stop taking drugs within the 1st year

Question 10

evaluation: ethical issues

Answer 10

p: there may be ethical issues with the use of drugs
e: antipsychotics may have been used in hospital situations to calm patients and make them easier for staff to work with, rather than benefit the patients
c: weakness because this practice of using antipsychotics as sedation is seen by some as human rights abuse.. this raises ethical issues of the use of antipsychotic drugs with patients

Question 11

evaluation: is drug therapy for everyone

Answer 11

p: appropriateness of drug therapy for everyone
e: not all sufferers will respond in the same way to antipsychotics
around 30% of sufferers will not respond favourably.
antipsychotics primarily help with only the psoitive symptoms of schizophrenia, the negative symptoms thus have to be addressed with other drugs or with psychological treatment
c: weakness because drug therapy alone is not a universally effective treatment for schizophrenia