Outline and evaluate the biological therapies for schizophrenia

• 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.

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

• 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

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