Biological Therapy

• Antipsychotics are drugs used to reduce the intensity of symptoms (mainly positive) of schizophrenia
• Typical Antipsychotics are the first generation of antipsychotics developed in the 1950s e.g. Chlorpromazine
• Typical Antipsychotics work as dopamine antagonists by blocking DA receptors at synapses in the brain
• Typical Antipsychotics have a sedation effect as they calm individuals
• The sedation effect may be linked to the effect of antipsychotics on histamine receptors
• Atypical Antipsychotics are the later generation of antipsychotics developed in the 1970s e.g. Clozapine, Risperidone
• Atypical Antipsychotics target a range of neurotransmitters
• Clozapine binds to dopamine, serotonin, and glutamate receptors to reduce depression & anxiety and improve cognitive functioning
• Clozapine is often prescribed when patient is at high risk of suicide
• Risperidone binds to dopamine and serotonin receptors more strongly than clozapine and with fewer side effects
• Clozapine cannot be taken as an injection due to the fatal cases of patients developing the blood condition agranulocytosis
• The average dose for chlorpromazine is 400-800 mg
• The average dose for clozapine is 300-450 mg
• The average dose for risperidone is 4-8 mg
• There is evidence for the effectiveness of typical antipsychotics e.g. Ben Thornley et.al.
• Ben Thornley et.al. compared the effects of chlorpromazine to a control condition in 13 trials and found better overall functioning and reduced symptom severity
• There is evidence for the effectiveness of atypical antipsychotics e.g. Herbert Meltzer
• Herbert Meltzer concluded that clozapine is more effective in 30-50% of cases where typical antipsychotics have failed
• A limitation of evidence for antipsychotics is that most studies only observe the short-term effects
• A limitation of antipsychotics is that the calming effect produced may not remove the actual symptoms
• There are serious side effects of antipsychotics e.g. dizziness, agitation, stiff jaw, tardive dyskinesia, neuroleptic malignant syndrome
• Tardive Dyskinesia is a side effect of antipsychotics that causes involuntary facial movements e.g. grimacing, blinking
• Neuroleptic Malignant Syndrome (NMS) is a side effect of antipsychotics where the drugs block dopamine receptors in the hypothalamus, resulting in high temperatures, delirium, coma, or death
• A limitation of antipsychotics is that the mechanism is unclear, as the updated dopamine hypothesis (hypodopaminergia) suggests that most antipsychotics should not work
• The Chemical Cosh is the idea that patients who are put to sleep or behaviourally managed by drugs may not be fully consensual or that it is only benefitting hospital staff