Outline and evaluate the biological therapies for schizophrenia

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AO1 - Anti-psychotics

  • Antipsychotic medication is mainly used to reduce the positive symptoms of Sz 
  • Schizophrenics show high numbers of dopamine 'D2' receptors which causes more dopamine to bind and more neurons firing
  • Anti-psychotics work by blocking dopamine receptors
  • Dopaminergic neurons have an important role in perception and attention processes. 
  • Overactive dopamine system results in too much attention which could give impression of disordered though.
  • Too much perception means an individual could perceive things which arent really there i.e. hallucinations
  • Anti-psychotics are divided into 2 main types: typical and atypical.
  • Typical (conventional) drugs are generally older (1950s) e.g. chlorpromazine 
  • Atypical = newer drugs developed in the 1990s e.g. clozapine
  • Typical drugs work by dopamine receptors thereby reducing +ve symptoms wherease atypical drugs act on serotonin as well as dopamine and attempt to reduce the negative symptoms.
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AO2 - Anti-psychotics

Support

  • May et al 1981 found that patients reported a reduction in sz symptoms soon after administration, and chlorpromazine is seen as the most effective treatment of Sz today
  • Kane 1992 - chlorpromazine had been found to be more effective than phenothiazines, 80-85% of sz's responded positively to chlorpromazine whereas 60-75% of sz's responded positively to phenothiazines
  • Silverman et al 1987 stated that antipsychotics have beneficial side effects for some people by increasing levels of attention and information processing

Criticisms 

  • Drugs treat the symptoms and not the cause
  • Sufferers can become dependant on drugs and higher and higher doses are needed over time
  • 20-25% typical drug users will develop tardive dyskinesia (disordered motor movements) which is irreversible in some cases
  • Other side effects of typical drugs are: blurred vision, weight gain, seizures
  • Atypical drugs have fewer side effects but include: restlessness, sleep problems and agranulocytosis (low white blood cell count) 
  • Around 30% of sufferers will not respond favourably to antipsychotics
  • Only seem to act on positive symptoms and not negative symptoms
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AO1 - ECT

  • Electroconvulsive therapy (ECT) not the main treatment for Sz and is only used for severe cases of catatonic schizophrenia
  • Electrodes are placed either bilateral (both temples) or unilateral (one temple) and an 0.6 amp electric current is passed through the brain for less than one second
  • Before this the patient is injected with a short acting barbiturate so they are unconscious before the shocks are administered and also given a muscle relaxant
  • Patients usually need 3-15 treatments to achieve the desired reduction in symptoms
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AO2 - ECT

Support

  • Tharyan and Adams 2005 found real ECT was more effective than placebo/simulated ECT in terms of improvement of patients

Criticism

  • Not understood how ECT works so its appropriateness as a therapy is questioned
  • Risks include short-term memory impairment for past events and current events and occurs in 1 in 10000 patients 
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