Biological Therapies for Schizophrenia Flashcards
(4 cards)
Primary biological treatment
The primary biological treatment for schizophrenia is antipsychotic medication, which works by targeting neurotransmitter systems, primarily dopamine.
Antipsychotics are typically taken long-term and often form part of a multi-treatment plan, sometimes alongside CBT or family therapy.
Two types of anti-psychotic drugs
Typical (first-generation) antipsychotics, such as chlorpromazine, act as dopamine antagonists, blocking dopamine D2 receptors in the mesolimbic pathway. This reduces positive symptoms such as hallucinations and delusions, which are thought to result from dopamine hyperactivity.
Atypical (second-generation) antipsychotics, such as clozapine, act on dopamine and serotonin systems. Clozapine binds to dopamine receptors more loosely and also affects serotonin (5-HT) and glutamate receptors, aiming to reduce both positive and negative symptoms like avolition and anhedonia.
AO3 advantages
A key strength of antipsychotics is their demonstrated effectiveness. Leucht et al. (2012) conducted a meta-analysis of 65 studies involving over 6,000 patients and found that antipsychotics were significantly more effective than placebos in preventing relapse and reducing symptoms. This study provides lots of support for antipsychotics, especially for short-term symptom management during acute episodes.
antipsychotics are often effective in improving patients’ ability to engage with psychological therapies. NICE recommends using them along with CBT, reflecting a more interactionist approach that is now considered the best practice in modern psychiatry.
AO3 disadvantages
Typical antipsychotics can lead to extrapyramidal symptoms such as tardive dyskinesia, involving involuntary facial movements and tremors. Even atypical antipsychotics, despite being designed to reduce side effects, can cause weight gain and increased cardiovascular risk. These side effects reduce treatment adherence, undermining long-term effectiveness and patient well-being.
Another criticism is that drug therapy is biologically reductionist. It targets brain chemistry, particularly dopamine, but ignores psychological and social factors that may contribute to schizophrenia, such as cognitive distortions, childhood trauma, or family dysfunction. Therefore, it may treat symptoms but not underlying causes, leading to a risk of relapse once medication is stopped.
Newer research suggests SZ results from dysregulated dopamine pathways, not simple excess. Furthermore, other neurotransmitters like glutamate and GABA may also be involved, suggesting that current drugs are only addressing part of the problem.
