Biological therapies

Question 1

What are antipsychotics?

Answer 1

Drugs used to reduce the intensity of symptoms of psychotic conditions.

Question 2

What are typical antipsychotics?

Answer 2

The first generation of antipsychotic drugs (1950s). They target dopamine reducing the positive symptoms of schizophrenia. Can produce movement side effects.

Question 3

How do typical antipsychotic drugs work?

Answer 3

Act as dopamine antagonists (works against dopamine)  they bind to dopamine receptors at the postsynaptic neuron and block the action of dopamine.

Question 4

What are atypical antipsychotics?

Answer 4

The second generation of antipsychotic drugs. They target dopamine and serotonin, reducing positive and negative symptoms of schizophrenia.

Question 5

How do atypical antipsychotic drugs work?

Answer 5

Also act as dopamine antagonists, but also block the action of serotonin.

Question 6

What is an example of a typical antipsychotic?

Answer 6

Chlorpromazine

Question 7

What are 2 examples of an atypical antipsychotic?

Answer 7

Clozapine and Risperidone

Question 8

What are the two strengths of biological therapies?

Answer 8

Evidence for effectiveness:
Leuch et al. (2012)- carried out a meta-analysis involving nearly 6,000 patients- some taken off their antipsychotic medication and given a placebo instead. The remaining patients remained on their regular antipsychotics. Within 12 months, 64% of placebo patients had relapsed, compared to 27% of those who stayed on the antipsychotic drug.
COUNTER-ARGUMENT: Some successful trials have had their data published multiple times, exaggerating the evidence for positive effects. It is also suggested that because antipsychotics have powerful calming effects, it is easy to demonstrate that they have some positive effect on patients. This is not the same as saying they really reduce the severity of psychosis.

Advantages of atypical over typical antipsychotics:
A key advantage of atypical antipsychotics is that patients experience fewer side effects- less likely to result in movement problems commonly found with typical antipsychotics.
As a result patients are more likely to continue with their medication, which in turn means they are more likely to see a reduction in their symptoms.
COUNTER-ARGUMENT: Crossley et al. (2010)- carried out meta-analysis to examine efficacy and side effects of atypical drugs. Found that although atypical antipsychotics did reduce side effects there was no significant differences between atypical and typical drugs in terms of their effect on symptoms of schizophrenia.

Question 9

What are the two limitations of biological therapies?

Answer 9

Serious side effects:
Typical antipsychotic drugs can sometimes produce movement problems for the patients.
The most common are the Parkinsonian and related symptoms- they resemble features of the neurological disorder Parkinson’s disease (PD). More than half of the patients taking typical antipsychotics experience these symptoms. When taken for an extended period can lead to dyskinesia= involuntary movements of the tongue, face and jaw.

Motivational deficits:
It is argued that when people are prescribed antipsychotic medication, it reinforces the view that there is ‘something wrong with them’.
This prevents the individual from thinking about possible stressors (such as life history or current circumstances) that might be contributing to their condition. In turn this reduces their motivation to look for possible solutions that might alleviate these stressors and reduce their suffering.
As human misery is largely inflicted by other people then the best solutions are usually human interventions, rather than chemical.