Treatments for Schizophrenia

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There is an immediate need to alleviate the psychological problems like schizophrenia which are distressing to the sufferer, using forms of therapy. Chemotherapy is one form of treatment, and this uses antipsychotic drugs. Phenothiazines such as chlorpromazine are used to treat schizophrenia. Another group of antipsychotics used include chlorpromazine. New ‘atypical’ antipsychotics have been developed e.g. clozapine and are less likely to cause extrapyramidal symptoms. Clozapine is the first atypical drug shown to be effective in treating participants who failed to respond to ‘typical’ antipsychotics like chlorpromazine (Gelder et al 1999). 

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Extrapyramidal Symptoms

Extrapyramidal symptoms are disabling side effects which tend to affect patients receiving long term treatment, and they include akathisia (severe restlessness and agitation), acute dystonia (involuntary muscle contraction) and tardive dyskinesia, a late onset irreversible movement disorder, involving involuntary facial movements and affects 25% of all patients who have taken antipsychotics for more than 7 years.

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Jeste et al

Found tardive dyskinesia rates after 9 months of treatment of 30% for conventional antipsychotics but just 5% for atypical antipsychotics, meaning atypical antipsychotics are more appropriate as they have fewer side effects so patients are more likely to see more of the benefits of the treatment.

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Antipsychotics work by blocking D2 dopamine receptors, resulting in reduced synaptic activity in neurons which utilise dopamine which has been implicated to cause schizophrenia symptoms. The use of antipsychotics became popular in the 1960s and 1970s.

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Found that prior to the 1980s it was estimated that 2 of 3 patients would spend their lives in a psychiatric institution, however post-1980s the average length of stay is down to around 2 months, showing an improvement in the therapy meaning patients weren’t required to stay in an institution for as long. 

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Antiphycotics Evaluation

Psychoactive drugs usually relieve suffering quickly and form a relatively inexpensive treatment when compared to psychological therapies, so this is useful as more people can be treated due to the costs being low. Maintenance Drug treatment can prevent schizophrenic patients relapsing, so this shows it is effective in relieving the suffering and making sure it does not return. It also makes logical sense to treat the result of biological factors physically i.e. with drugs. However, the side effects discussed can be very disabling to the patients, and original antipsychotics were only effective in treating positive (not negative) symptoms, so some types of schizophrenia could not be treated with these typical drugs.

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Davis et al

Analysed the results of 29 studies and found that relapse occurred in 55% of patients whose drugs were replaced with a placebo, but was significantly less (19%) for those who remained on the drug.

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Ross and Read

Pointed out these results are misleading because they also show that 45% of patients did not relapse when on the placebo, suggesting a significant number did just as well using the placebo therapy. Ross and Read also argue that being prescribed medication reinforces the view that there is something wrong with you, preventing the individual from looking for and dealing with possible stressors that may be responsible for their illness.

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Leucht et al

There has also been evidence that newer, atypical antipsychotics may only be moderately superior to conventional antipsychotics suggesting they may not be the answer to treating schizophrenia

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