Therapy

Biological Therapies for Schizophrenia

Antipsychotic Medication

Antipsychotic medication helps the person with the disorder function as well as increasing their feelings of subjective wellbeing. Conventional Antipsychotics e.g. chlorpromazine targets he overactive dopamine system and combats postive symptoms. Atypical Antipsychotics e.g. clozapine claim they can treat positive and negative symptoms.

Conventional antipsychotic drugs

• Basic mechanism is to reduce effects of dopamine.
• Dopamine antagonists in that they bind the dopamine receptors but do not stimulate them, blocking their action. By reducing stimulation of the dopamine system in the brain, hallucinations, dellusion and experiences of control can be eliminated.

Effectiveness of conventional antipsychotics:

• Relapse rates: Comparing relapse rates with those on medication and those on placebo. Review by Davis et al., (1980) found significant difference in terms of relapse rates between treatment and placebo groups in every study reviewed, demonstrating effectiveness of the drugs. (analysed 29 studies. Relapse occured in 55% of the patients whose drugs were replaced by a placebo, and 19% of those who remained on the drug. Ross and Read (2004) said these results were misleading as they also indicate 45% of those on the placebo benefited!
• One of the studies in Davis et al., (1980) found that antipsychotic medication did make a difference, but only for those living with hostility and criticism. In such conditions, relapse rates for those on medication was 53%, but those on placebo was 92%. For those living in supportive homes there was little difference between the two.

Appropriateness of conventional antipsychotics:

• Tardive Dyskinesia: Drugs may have side effects. This disorder includes uncontrollable movements of the lips, tongue, face, hands and feets. About 30% on the meds will develp this, and it is irreversible in 75% of the cases, Hill (1986).
• Motivational Deficits: Ross and Read (2004) say that being perscribed the medication reaffirms the fact that there is something wrong with you. This prevents the person from thinking about possible stressors (e.g. life history) that may be a trigger for their condition, reducing their motivation to look for possible solutions.

Atypical antipsychotic drugs

• Also act on the dopamine system, but block serotonin receptors in the brain too.

Effectiveness of atypical antipsychotics:

• Atypical or conventional?: a meta-analysis (Leucht et al., 1999)…