Biological treatment of schizophrenia

• Chemotherapy:

  • It follows that if neurotransmitter functioning causes symptoms, drug treatments that affect such functioning can help to treat those symptoms.
  • Phenothiazines are used for this purpose, for example chlorpromazine, which acts by blocking dopamine receptors so that there is no excess dopamine.
  • Antipsychotic drugs.
  • Suppress symptoms.
  • Typical and atypical.
  • Atypical= newer and less widely used, have fewer side effects, act differently to typical drugs.
  • Chemotherapy- any treatment given by using drugs and chemicals.
• • First generation antipsychotics like PTZ are known as 'typical' antipsychotics they are also called neuroleptics. These drugs block dopamine activity within 48 hours and this seems to be why they are therapeutic for people with schizophrenia. However, it can take several weeks before there is any significant reduction in symptoms.
  • Although being able to treat schizophrenia with a pill brought about a huge change in mental health care . They had unpleasant symptoms dryness of mouth.
  • Blurred vision and groginess.
  • Weight gain
  • Sleep problems
• • Because these side effects are unpleasant, its difficult to keep patients on their medication once they are released from hospital.
  • The more serious side effects are even nastier:
  • muscle tremors and spasms
  • drooling
  • Patients on PTZ often developed a distinctive stumbling walk which was called 'the thorazine shuffle'
  • tardive dyskinesia, uncontrollable facial grimaces and tics. 25% of all patients than 7 years. Irreversible even if the patient stops taking the drugs.
• • Atypical antipsychotic (AAP), clozapine 1971. Risperidone 1993 and olanzapine 2000s.
  • Don't necessarily work by blocking dopamine receptors- scientists are unsure about the reason of effects. more powerful than typical antipsychotics, 'last resort'. PTZ are too severe.
  • 85% of patients with schizophrenia, compared with 65% given PTZ. Third of patients no improvement with PTZ well to clozapine. Negative symptoms as well as positive symptoms.
• Atypical Antipsychotics:

  • The second generation seemed to have fewer side effects.
  • AAPs produce their own side effects like diabetes.
  • TD is a possible side effects with AAPs as well, but onset takes longer.
  • Produce withdrawal important to come off medication slowly.
• Real life:

  • Antipsychotic clients medical history and the previous medication they have tried.
  • (NICE 2014) doctors should discuss the benefits and side effects of each antipsychotic with the patients and family members.
  • Drug doesn't work well or causes too many side effects, a doctor will probably change the prescription and try another drug.
  • No effect, a different antipsychotic 4-6 weeks. Prescribe AAPs: clozapine not responded to other drugs.
  • Todays advice is not to offer people more than one antipsychotic drug at a time. Clozapine: second antipsychotic may be prescribed at the same time.
• • People with schizophrenia often take antipsychotics for years. They stop taking the drugs too soon, the symptoms may return.
  • At least half dont take their drugs as recommended. Dont like the idea of taking drugs everyday or forget to take them or decide they dont need them.
  • People said they stopped taking medication because they missed hearing voices.
  • Does not work for everyone. 25% of people who are prescribed antipsychotics dont get better. ' treatement resistant'
• Meltzer 2004:

  • 481 schizophrenia patients
  • Groups included a placebo, haloperidol (antipsychotic) and new drugs
  • 6 weeks
  • recorded +/- symptoms, severity and score on psychiatric rating scale
  • Haloperidol was better than the placebo (study valid)
  • 2 new drugs showed improvement
  • So drugs are better then no drugs
• Mertzer Side effects:

  • Sleepiness
  • Shaking and muscle spasms
  • Low blood pressure
  • Low sex drive
  • Weight gain
• Evaluation: +

  • Drugs are better than what used to happen
  • As causes have strong biological evidence it supports the use of drugs
• Evaluation: -

  • People do not continue with drugs.. could be due to negative side effects.
  • A chemical straight jacket to just make people conform
  • Mostly helps with positive symptoms. Can have bad side effects
  • Doesn't take into consideration environment.
  • Is it just making money?