Biological Treatments of Schizophrenia (Paper 3)*

Question 1

Outline typical antipsychotics.

Answer 1

Developed in 1950s, originally developed as an anti-histamine to treat allergies.

Question 2

Give an example of a typical antipsychotic.

Answer 2

Chlorpromazine - first drug used to treat psychosis.

Question 3

How do typical antipsychotics work?

Answer 3

Tightly bind to dopamine receptors, then they slowly dissociate from the receptors - increasing the amount of dopamine that binds.

Question 4

What is the effect of taking typical antipsychotics?

Answer 4

Decrease positive symptoms though with little effect on negative symptoms.

Question 5

Give some examples of the side effects associated with taking typical antipsychotics.

Answer 5

Extrapyramidal side effects such as movement deficits as dopamine plays a role in motor control.

Question 6

Outline atypical antipsychotics.

Answer 6

Developed in the 1970s, primarily used on patients with no response to other antipsychotics.

Question 7

Give an example of an atypical antipsychotic.

Answer 7

Clozapine - the first atypical to be used to treat SZ.

Question 8

How do atypical antipsychotics work?

Answer 8

Loosely bind and rapidly dissociate from dopamine receptors. Giving dopamine a limited ability to bind to receptors.

Question 9

What is the effect of taking atypical antipsychotics?

Answer 9

• Successful in treating positive and negative symptoms.

- Also able to reduce avolition and suicidal thoughts - effects 30-50% of schizophrenics.

Question 10

Give some side effects of atypical antipsychotics.

Answer 10

Agranulocytosis - decrease of lymphocytes - increasing the chance of infection - only affects 1% of those who take the drug.

Question 11

Give two advantages of drug therapy in the treatment of schizophrenia.

Answer 11

Advantages:
- Supporting evidence for efficacy - Leucht et al. - meta-analysis of 65 studies - 6000 patients - patients taken off antipsychotic treatment and given placebo - 64% of these had relapsed compared to 27% of those who continued on the antipsychotic treatment.

• Drugs are inexpensive and can be applied immediately - high relapse rate leads to more hospitalisations - may end up costing more in the long term - the most appropriate treatment would be an interactionist treatment.

Question 12

Give two disadvantages of drug therapy as a treatment for schizophrenia.

Answer 12

Disadvantages:
- Many studies refute the validity of evidence for drugs’ efficacy - Healy - data from some studies was published multiple times - exaggerating the evidence for improvement - publication bias - usually studies that support drug therapy are published.

• Serious side effects - Crossley et al. - meta-analysis - 15 studies - patients on atypicals gained weight and those on typicals experienced more extrapyramidal side effects - different patients will experience different side effects - an ideographic approach to treatment is required - not delivered by drug therapy.