Biological treatments for schizophrenia

• Outline the biological treatment for schizophrenia.

  Typical antipsychotics (e.g. chlorpromazine) were the first antipsychotic drug to be produced. They work by decreasing dopamine activity.

  It does this by blocking D2 receptors so that dopamine cannot bind to them and exert their effects.

  By reducing dopamine activity, typical antipsychotics treat the positive symptoms of schizophrenia (e.g. delusions and hallucinations).
• Outline the biological treatment for schizophrenia. Refer to both typical and atypical antipsychotics.

  Atypical antipsychotics (e.g. clozapine) are the newer type of antipsychotic that decreases dopamine activity while also affecting other neurotransmitters such as serotonin.

  They block D2 receptors to reduce dopamine activity, but they do this for a shorter period of time. They also block serotonin receptors, preventing serotonin from binding and exerting its effects.
• Compare typical and atypical antipsychotics.

  Typical antipsychotics only reduce dopamine activity to treat the positive symptoms of schizophrenia. In contrast, atypical antipsychotics reduce dopamine and serotonin activity to treat positive and negative symptoms of schizophrenia. This makes atypical antipsychotics a more effective treatment, particularly for those experiencing negative symptoms.
• Compare typical and atypical antipsychotics.

  Both produce side effects such as agitation, dizziness, weight gain etc. This is a limitation of both as it means patients may stop taking their medication. This could, in turn, lead to relapse.
• Compare typical and atypical antipsychotics.

  Typical antipsychotics are more likely to lead to movement disorders than atypical antipsychotics. This is because dopamine plays a role in movement and atypical antipsychotics do not block dopamine activity for as long as typical antipsychotics. This can make atypical antipsychotics a more appropriate drug to prescribe.
• Evaluate antipsychotics as used to treat schizophrenia: evidence for their effectiveness. 


  E.g. research has found that most people with schizophrenia (70%) report a reduction their symptoms when taking antipsychotics. In contrast, only a minority report a reduction in their symptoms when taking a placebo. This is a strength as it suggests antipsychotics are effective and that this effect is not a result of a placebo effect.
• Evaluate antipsychotics as used to treat schizophrenia: not effective for every patient.


  This is because 30% of patients did not report a reduction in their symptoms when taking antipsychotics. This is a limitation because it suggests that their schizophrenic symptoms are not a result of abnormal neurotransmitter levels and instead may be due to environmental factors such as family dysfunction. In this case, family therapy or CBT may be a more appropriate treatment than antipsychotics.
• Evaluate antipsychotics as used to treat schizophrenia: do not treat the root cause of schizophrenia.

  This is because there are high relapse rates (i.e. symptoms return) when they are no longer taken. This is a limitation because it suggests that the drugs only suppress the symptoms but do not address the root cause. Indeed, some have argued that antipsychotics only work because they produce a sedative effect and so are used, particularly in hospitals, to calm patients rather than to treat their disorder.
• Evaluate antipsychotics as used to treat schizophrenia: produce side effects.


  E.g. some side effects include agitation, dizziness, and weight gain. Long-term use of typical antipsychotics can also result in movement disorders. This is a limitation because these side effects can make a patient stop taking their medication which, in turn, leads to relapse. In contrast, CBT may be considered a better treatment because it is a talking therapy so produces no side effects. This means patients are unlikely to drop out of the therapy so are more likely to be successfully treated.
• Evaluate antipsychotics as used to treat schizophrenia: easily accessible.

  This is because they can be prescribed at little cost and time in comparison to talking therapies such as CBT which have long waiting lists and require a trained therapist. This is a strength as it means this treatment can be given to more people suffering from schizophrenia, thus benefiting more people.