Biological Therapies

Question 1

✅ ATYPICAL ANTIPSYCHOTICS-PSYCHOTICS HAVE AN IMPROVED SIDE EFFECT PROFILE:

Answer 1

• A key benefit is that patients taking atypical antipsychotics experience fewer extrapyramidal side effects, such as involuntary movements and rigidity, which are common with typical antipsychotics.
• The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study (2005), a double-blind investigation involving over 1400 patients, found that while only 26% of patients continued taking any drug for the full 18-month period, time to discontinuation was greater for olanzapine (an atypical) than other antipsychotics, including the typical perphenazine.
  • While this suggests that atypical antipsychotics improve patient compliance and treatment efficacy, the low level of subjects who completed the 18-month study (26%), indicates that tolerance is low to both typical and atypical antipsychotics, and even olanzapine produced significant weight gain and metabolic issues.
• The reduced side effects enhance the ethical acceptability of atypical drugs, making them a more reliable and valid treatment option for schizophrenia, at least for some patients.

Question 2

❌THE LONG-TERM EFFICACY FOR ANTI-PSYCHOTICS HAS BEEN CHALLENGED:

Answer 2

• Healy (2012) argues that many published studies are of short duration and have been published multiple times, creating an exaggerated impression of the evidence available. This suggests that while antipsychotics may have powerful calming effects in the short term, their long-term effectiveness is questionable. Prolonged treatment is also associated with significant side effects, such as weight gain, tardive dyskinesia, and cardiovascular issues, which may reduce patient compliance.
• These findings cast doubt on the reliability of research into antipsychotics, as it often fails to consider the long-term risks and benefits.
• Therefore, the evidence supporting antipsychotics may not be as robust as it initially appears, limiting the application, highlighting the need for further independent, long-term studies to determine their true effectiveness and ensure that their benefits outweigh the associated risks.

Question 3

❌ THERE ARE ETHICAL ISSUES GIVEN THE SEVERITY OF SIDE EFFECTS:

Answer 3

• Critics argue that when side effects, deaths, and psychosocial consequences are considered, the cost-benefit analysis of antipsychotics may be negative. For example, severe side effects such as tardive dyskinesia and neuroleptic malignant syndrome can have lasting impacts on a patient’s quality of life. Additionally, it has been questioned whether severely ill patients with schizophrenia are sufficiently capable of giving informed consent to such treatments.
• This suggests that the costs of antipsychotic medication, both physical and ethical, may not outweigh the benefits of symptom reduction. From an ethical perspective, the autonomy and well-being of patients must be prioritised, yet these treatments may compromise these principles.
• Therefore, while antipsychotics can improve functioning, concerns about their risks and the ability to secure genuine informed consent put into question both the ethics and the overall effectiveness and acceptability of such biological therapies.