Biological treatments for Schizophrenia

Question 1

A01

How do Antipsychotics work?

Answer 1

There are two types of antipsychotics which are used to treat SZ - typical and atypical
Antipsychotics are given to treat (Sz)
Once ingested, chemicals in antipsychotics work by binding to dopamine receptors (these are called D2 receptors)
thus blocking the action of the receptors, not stimulating them
Reducing the stimulation of the dopamine system can eliminate the hallucinations & delusions experienced by patients with Sz
The effectiveness of these dopamine antagonists in reducing the symptoms of Sz is what led to the development of the dopamine hypothesis

Question 2

A01

Outline Typical antipsychotics

First generation

Typical antipsychotics more effective at treating positive symptoms, typical antipsychotics known as first generation antipsychotics been in use since 1950s

Answer 2

Typical antipsychotics include chlorpromazine which can be taken as tablets, syrum or by injection.
Typical antipsychotics like chlorpromazine works by acting as a antagonist in dopamine system
* Dopamine Antagonists work by blocking dopamine receptors (DZ)in synapse of brain , reducing action of dopamine
* initally when person takes chloropromazine DOP levels build up but than production reduced according to dop hypothesis, this dop antagonist effect normalises transmission in areas of brain reducing symptoms like halluncinations
chloropromazine can also be used as a sedative to calm those with SZ down,

(dopamine antagonists are chemicals which reduce the action of neurotransmitters)

Question 3

A01

Outline Atypical antipsychotics

second generation

Atypical antipsychotics treat both positive symptoms and negative symptoms of SZ

Answer 3

Atypical antipsychotics treat both positive symptoms & negative symptoms of SZ
The medications commonly used are clozapine & risperidone
atypical antipsychotics (Clozapine) also bind to D2 receptors but instead they temporarily bind to the receptors (rather than block) and then rapidly dissociate to allow normal levels of DA transmission
Clozapine also works on serotonin & glutamate receptors, which reduce depression & anxiety, and in turn, improve mood & cognitive functioning
clozapine is prescribed when other antipsychotic drugs do not work

Question 4

A03

research support for effectiveness of typical antipsychotics-thornley et al

strength

Answer 4

There is evidence to support idea that typical antipsychotics are moderately effective in tackiling symptoms of SZ
Thornley et al (2003) reviewed studies comparing the effects of chloropromazine to control conditions
Data from 13 trials with total of 1121 P showed that chloropromazine was associated with better overall functioning & reduced symptoms severity compared to placebo

Question 5

A03

Serious side effects

Limitation

Answer 5

A problem with antipsychotic drugs is the likelyhood of side effects,
* typical antipsychotics associated with range of side effects including dizziness, agitation, sleepiness , weight gain,
* serious side effects for Atypical antipsychotics-neuroleptic malignant syndrome NMS, resulting in high temperature, coma that are fatal- thus side effects sig weakness

Question 6

A03

The chemical cosh argument

Counterpoints

Answer 6

It is believed that antipsychotics have been used in hospital situations to calm ppl with SZ & make them easier for staff to work with , rather than benefits to the people themselves
but calming people distressed by hallucinations & delusions can also make them feel better & allow them to engage with other treatments ( CBT)

Question 7

A03

The development of antipsychotics was based on dopamine hypothesis

Limitation

Answer 7

development of antipsychotics was based upon dopamine hypothesis, so their
use depends on this theory too.
* E.g if antipsychotics appear to alleviate symptoms by reducing the action of dopamine, this supports the original dopamine hypothesis i.e.
hyperdopaminergia in the subcortex.
* However, this action is not in line with revised version of the dopamine hypothesis, which suggests abnormally low levels of dopamine in the cortex are
responsible for symptoms.
Thus, a further reduction in dopamine levels should make symptoms
worse, and not better.
This paradox has caused some to question validity of use of
antipsychotics, as well as accuracy of the dopamine hypothesis as an explanation for
schizophrenia.