Biological Therapies AO3

• what is research evidence for effectiveness of atypical drugs?

  • differs in person to person
  • Lobos 2010 - compared clozapine with number of other atypical antipsychotics and found clozapine faired favourably in reducing positive side-effects
  • however - high attrition rates due to serious side-effects so may lack effectiveness due to distress caused by side-effects
  • key when taking medication outside hospital, SZs may struggle to adhere to medication schedule, 'revolving door psychiatry', stop taking due to unbearable side-effects or unorganised tendency to not take
  • undermines effectiveness
• what are ethics arguments of biological treatments for SZ?

  • side-effects may be worse than SZ itself, perhaps medication isn't best option e.g. weight gain can lead to diabetes, heart disease and high blood pressure which would be more detrimental to schizophrenic than SZ itself
  • however, antipsychotics are successful, not perfect but best we have atm
  • however Szasz - antipsychiatry movement, medication like straightjacket, conform to societies 'normal'
  • are side-effects and underlying motivations of control worth it in antipsychotic use?
• what is an appropriateness/social implication arguments?

  • revolutionary in SZ treatment, specifically chloropromazine, allowing society to move on from cruel and ineffective treatments , and allow more successful/appropriate ones to be put in place
  • expensive - both long-term treatment and not treating until later on are expensive in relation to other therapies, especially if side-effects are caused like weight gain/diabetes which also need to be treated
  • however, may be heartless to discuss cost when people are suffering from a serious mental illness which could be treated
• what is a counter study for Lobos 2010?

  • Valenstein et al 2004 - performed a huge study on over 63000 schizophrenics taking antipsychotics
  • found 40% of cases adherence to regime was poor - missed/refused to take
  • only drug that this wasn't an issue was clozapine that only had 4.6% patients showing poor adherence
  • varied for different groups - young less likely to adhere than older, African-Americans less likely to adhere than white Americans - cultural differences, symptoms don't count?