SCHIZOPHRENIA - Biological treatment of schizophrenia (sch)

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  • Biological treatment of schizophrenia (sch)
    • Antipsychotic drugs
      • reduce effect of dopamine in the brain (antagonist)
      • 2 types:
        • typical antipsychotics
        • atypical antipsychotics
    • Typical (conventional) antipsychotics
      • bind but do not stimulate D2 receptors -> blocks them
      • chlorpromazine -> work with reducing positive (not negative) symptoms
      • within few days of taking drugs, symptoms will reduce effectively
      • psychotic episode -> drugs take away psychosis
      • Kapur -> 60-75% of receptors in mesolimbic pathway need to be blocked for drug to be effective
      • unfortunately, does block other receptors (side effects)
        • patients feel better, stop taking drugs -> symptoms return
      • permanently block receptors upon regular intake of drug
    • Atypical antipsychotic drugs
      • more recent than typical drugs (1980s)
      • 3 main differences:
        • fewer side effects
        • evidence that they may help some negative symptoms
        • only temporarily block receptors (rapid dissociation)
      • clozapine -> attracted to serotonin receptors
        • too little serotonin = depression. Too much = sch
    • Evaluation (A03)
      • Leucht -> meta-analysis 65 studies between 1959 and 2011 involving 6,000 PPs. PPs taken off antipyschotic drugs and given placebo. After 12 months, 64% of PPs taking placebo had relapsed (bad thing).
      • extrapyramidal side effects typical (cuases damage to extrapyramidal side of brain): movement problems, Parkinson's disease. If taken for long enough, tardive dyskinesia
      • drug companies promote atypical drug therapy for sch (profit) even though they know they are not perfect. They have patents on drugs (no one else can produce them - they get more £)
      • cheap compared to talking therapy & CBT etc. Good for health services when £ is low
      • convenient and easy to use (tablets), not much commitment
      • quick treatment, effective. Talking therapy takes more time
      • if it causes side effects, deaths or psychological damage, the treatment = unethical
      • patients suffer less side effects on atypical drugs (particularly olanzapine and quetiapine)
      • Crossley -> meta-analysis of 15 studies, found no signif differences between atypical & typical drugs, but did not difference between side effects. Atypical drugs = more weight gain. Typical drugs - more extrapyramidal side effects
      • Ross & Read -> when people are prescribed the drugs, they believe 'something is wrong with THEM'. prevents individs thinking about possible environmental stressors.

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