Biological Treatments of Schizophrenia

Question 1

Most commonly used treatment for schizophrenia

Answer 1

Antipsychotics - split into:
- older, TYPICAL antipsychotics
- newer, ATYPICAL antipsychotics

Question 2

How long can you take antipsychotics?

Answer 2

Short term: short course + has no returning symptoms
Long term: life long

Question 3

Typical Antipsychotics

Answer 3

Been used since the 50s
- bind to DA receptors + block production
- reduces positive symptoms e.g. hallucination

e.g. chloropromazine - has a sedatory effect - believed to have an effect on histamine receptors (not fully understood)

Question 4

Atypical Antipsychotics

Answer 4

Been used since the 70s
- a range that don’t all work the same
- bind to DA + other neurotransmitters

Question 5

Clozapine - an atypical antipsychotic

Answer 5

Binds to DA receptors like chloropromazine as well as serotonin + glutamate

=> believed to improve mood/cog functioning + reduce depression/anxiety
=> often used when suicide is at risk
=> side effect of agranulocytosis

Question 6

Risperidone - an atypical antipsychotic

Answer 6

Developed in the 1990s to be as effective but safer than clozapine => doesn’t cause agranulacytosis

• binds to DA + serotonin receptors
• binds to DA receptors more strongly => more effective at smaller doses than other antipsychotics
• fewer side effects

Question 7

(S) Evidence for Anti-psychotics effectiveness - Throney et al (2003)

Answer 7

Throney et al (2003) - Reviewed data from 13 trials
Found chlorpromazine was associated w/ better functioning + reduced severity compared to placebo

Healey (2012) - clozapine (atypical) is more effective than typical antipsychotics => 30-50% more effective in treatment resistant cases

=> Suggests - both typical and atypical are effective treatments for SZ

Question 8

(L) Side effects of antipsychotics

Answer 8

Typical - dizziness, agitation, sleepiness, weight gain + itchy skin

=> long term use can lead to lip-smackin + grimacing due to DA super-sensitivity (tardive dyskinesia)

=> most seriously neuroleptic malignant syndrome (NMS) - blocked DA in hypothalmus leads to delirium coma or death

Means => sufferers may stop taking them reducing effectiveness

Question 9

(L) Theoretical objections to use of anti-psychotics - not entirely sure how they work

Answer 9

• The use of these drugs is tied with the DA hypothesis => atypical levels of DA in subcortex of SZ sufferers
• However, evidence shows this may not be right - DA in cortex is too low as well - if so, drugs shouldn’t work

Suggests => drugs may be ineffective esp. for negative symptoms + that another factor is involved in their success

Question 10

Evaluation Extra - Drugs used alongside other therapies

Answer 10

• Drugs often prescribed with other psychological treatments like CBT
• Reducing positive symptoms like hallucinations + delusions allows better engagement with therapy

Suggests => antipsychotics may still be effective treatment if combined with other treatment