treatments for schizophrenia

Question 1

Biological Therapy for Schizophrenia

Answer 1

• Most common therapy involves antipsychotic drugs

Question 2

Alternative therapy:

Answer 2

Hydrotherapy
- Wet rap/packing continuous bath, hot boxes – 36 degrees.

Question 3

Insulin therapy

Answer 3

• Wet shock
• Coma and seizures
• Not given muscle relaxant or anaesthetic.

Question 4

Antipsychotics

Answer 4

• Drugs used to reduce the intensity of symptoms, in particular the positive symptoms, of psychotic disorders such as schizophrenia.
• Psychosis involves a loss of contact with reality e.g., through hallucinations or delusions.
• These are taken as tablets or as syrup. However, some patients are given injections at regular intervals (no faking).
• Pills are taken for as long as the patient shows symptoms, however, when not present, the individual is known as having schizophrenia in remission.
• Other people may require antipsychotics for life or else face the likelihood of a recurrence of schizophrenia.
• Antipsychotics can be divided into typical and newer atypical or second-generation drugs.

Question 5

Typical antipsychotics

Answer 5

• The first generation of these types of drugs, used since the 1950s.
• Only work with dopamine.

Question 6

Chlorpromazine

Answer 6

• This drug uses what we have learned from the dopamine hypothesis.
• Specifically, it is a receptor antagonist, meaning, that it decreases the amount of the neurotransmitter dopamine available in the system by blocking the receptor sites at the postsynaptic neuron.
• We know that too much dopamine in a system seems to cause the positive symptoms of the disorder
• so, if too much dopamine in the mesolimbic system accounts for hallucinations, having less should diminish it.
• Also a sedative, due to its interaction with histamine receptors. This is valuable because it may help with some of the side effects of schizophrenia, such as their agitation, caused by their delusions and hallucinations.

Question 7

Reward system

Answer 7

• Dopamine is synthesised in the VTA
• VTA cells go to ventral striatum to the nucleus accumbens (brain’s pleasure centre)
• Cells release neurotransmitter dopamine to dopamine receptors in other cells.
• Dopamine transporters allow excess dopamine reuptake.
• When rewards are received, large amounts of dopamine released, and transporters aim to bring levels back to normal.
• Influences pre-frontal cortex & cerebellum.
• So, when a person takes cocaine, it blocks all the reuptake transporters, hence why people feel extra reward when taking cocaine.
• Psychotic drugs like chlorpromazine blocks receptor cells to prevent dopamine entering the systems and neurons firing, therefore reducing the additional brain activity that could lead to hallucinations and delusions.

Question 8

Atypical Antipsychotics

Answer 8

• Have been used since the 1970s.
• Aim was to maintain and improve upon the drugs ability to suppress psychosis, as well as reduce side effects.

Question 9

Clozapine

Answer 9

• Developed in the 1960s
• Taken at around 300/400mg per day but can cause agranulocytosis.
• Binds to dopamine receptors like chlorpromazine but also binds to serotonin and glutamate receptors.
• This helps improve mood and reduce depression/anxiety in patients. May improve cognitive functioning.
• Sometimes administered if the patient is considering suicide and is high risk (30/50% of schizophrenia patients try suicide).

Question 10

Risperidone

Answer 10

• Developed in the 1990’s
• Typical dosage of 4-8 mg, maximum of 12 mg.
• Binds to dopamine and serotonin but binds more strongly so needs much less of a dosage.

Question 11

why are clozapine and risperidone preferred to antipsychotic drugs

Answer 11

These two drugs may be preferred to typical antipsychotics because these drugs are more holistic in its effect, working on both the negative and positive factors, by binding to more than just dopamine.