Biological treatments

• Antipsychotics (dopamine antagonists)- reduce the action of dopamine in areas of the brain associated with symptoms of schizophrenia 
• Two types of antipsychotics

  • Typical
  • Atypical
• Typical antipsychotics

  • Bind to dopamine receptors without stimulating them
  • Reduces positive symptoms
• Kapur et al (2000)

  • estimated that 60-70% of receptors in the mesolimbic pathway must be blocked for typical antipsychotics to be effective
  • A similar number of receptors must be blocked in other areas of the brain
  • Leads to undesirable side-effects
• Chlorpromazine is a common typical antipsychotic
• Atypical antipsychotics

  • 2nd generation- reduced side effects
  • Temporarily block receptors
  • Act on serotonin and glutamine receptors
  • Reduce both positive and negative symptoms
• Strengths- supporting evidence

  • Thornley et al (2003)- Chlorpromazine reduced symptom severity more affectively than a placebo
  • Meltzer (2012)- Clozapine is effective in 30-50% of treatment-resistant cases where typical antipsychotics have failed
• Weaknesses

  • Flaws: Healy (2012)
  • Serious side effects- dizzy, weight gain, sleepy and tardive dyskinesia. Most serious is neuroleptic malignant syndrome where dopamine action is blocked in the hypothalamus- causes high temp, coma and fatality
• Healy (2012)

  • Drug trials were short term only
  • Some successful trials had their data published multiple times- overstating the amount of supporting evidence
• Moral dilemma

  • Can help patients engage with other treatment more effectively
  • Antipsychotics are used to sedate patients and make staff's jobs easier
  • Drugs can be dehumanising as they reduce the person's control and consent