biological therapies

Question 1

Drug therapy

Answer 1

most common treatment involves the use of antipsychotic drugs

Question 2

Antipsychotics

Answer 2

Reduce intensity of schizophrenia symptoms, especially positive ones (e.g. hallucinations)

Question 3

Typical antipsychotics

Answer 3

The first generation of drugs for schizophrenia and other psychotic disorders, having been used since the 1950s
Eg chlorpromazine

Question 4

Dopamine antagonists

Answer 4

Acting as antagonists for dopamine
- Reduce action of neurotransmitter
- Block dopamine receptors in synapses of brain
- Dopamine levels increase but then production is reduced
- Reduces hallucinations

Question 5

Sedation effect

Answer 5

Effective sedative - effect on histamine receptors
- Often used to calm down individuals with other conditions
- Syrup is absorbed faster than tablets so it tends to be given when chlorpromazine is used for its sedative properties

Question 6

Atypical antipsychotics

Answer 6

Drugs for schizophrenia (a psychotic disorder) developed after typical antipsychotics
- Typically target a range of neurotransmitters such as dopamine and serotonin

Question 7

Clozapine

Answer 7

Developed in 1960s - withdrawn 1970s caused blood condition called agranulocytosis
1980s - more effective than typical antipsychotics
- Need regular blood tests
- Not available as injection
Bind to dopamine receptors and acts on serotonin and glutamate receptors - improves mood and reduces depression and anxiety - prevents suicide

Question 8

Risperidone

Answer 8

More recent - 1990s
- Tablets, syrup or injection
- Bind to dopamine and serotonin receptors - binds stronger than clozapine
- Fewer side effects cause smaller dosage

Question 9

EVAL - evidence for effectiveness

Answer 9

P - strength as evidence to support effectiveness
E - Thornley et al - studies comparing effects of chlorpromazine to control conditions - data from 13 trials with a total of 1121 participants showed that chlorpromazine associated with better functioning and reduced symptoms between than placebo
E - Melter - clozapine more effective than typical antipsychotics and other atypical antipsychotics - effective in 30-50% of treatment-resistant cases where typical antipsychotics have failed
L - shows that they are effective treatments

P - However, Healy argues theres a serious flaw with evidence for effectiveness
E - most studies are of short-term effects only and some successful trials have had data published multiple times, exaggerating the size of the evidence base for positive effects
E - because antipsychotics have calming effects - positive effect on people experiencing the symptoms of schizophrenia - not same as saying they reduce severity of psychosis
L - evidence base for antipsychotic effectiveness is less impressive than it first appears

Question 10

EVAL - serious side effects

Answer 10

P - limitation as high likelihood of side effect
E - typical antipsychotics associated with side effects eg dizziness, agitation, sleepiness, stiff jaw, weight gain. Long-term can result in tardive dyskinesia - caused by dopamine supersensitivity - involuntary facial movements - can also cause neuroleptic malignant syndrome
E - NMS - caused when drug blocks dopamine action in hypothalamus - associated with regulation of number of body systems - high temperature, delirium, coma and can be fatal - 0.1% to 2%
L - antipsychotics can do harm as well as good and individuals who experience these may avoid such treatments which makes the treatment ineffective

Question 11

EVAL - mechanism unclear

Answer 11

P - limitation of antipsychotics is that we do not know how they work
E - understanding of mechanism by which antipsychotic drugs work strongly tried to original dopamine hypothesis
E - original dopamine hypothesis is not complete - dopamine levels are instead too low - antipsychotics should not work - questioning effectiveness so argued to be ineffective
L - at least some of antipsychotics may not be the best treatment to opt for - perhaps some other factors involved in success

Question 12

EVAL - the chemical cosh

Answer 12

P - widely believes antipsychotics used in hospital situations to calm people with schizophrenia
E - allows them to be easier for staff to work with rather than benefiting the people themselves - Moncrieff
E - however, calming people distressed by hallucinations and delusions almost certainly makes them feel better
L - allowing them to engage in other treatments such as CBT and other services