Drug Therapy - evaluation

• EFFECTIVENESS - agonist substitution (methadone) = effective for heroin addiction

  N.I.C.E - national institute for care and excellence = 31 reviews of methadone effectiveness > increased retention on treatment programmes + decreased illicit opioid use

  methadone = effective at retaining addicts on treatment programmes and off heroin

  no evidence of abstinence
• EFFECTIVENESS - antipsychotics = effective at treating schizophrenia

  Cole et al - conventional antipsychotics condition = 75% - much improved and none got worse

  - placebo condition = 25% improved and 48% got worse

  active chemicals in antipsychotics have beneficial effects

  published - 1964 = one of the first to show schizophrenia can be treated with drugs > patients don't need to be restrained in an institution } social importance
• EFFECTIVENESS - atypical (newer) antipsychotics = effective

  Lobos (2010) - compared clozapine with other atypical antipsychotic

  reduced positive symptoms but had risk of serious side effects > increased drop out

  modern research supports antipsychotic effectiveness, but highlights they need to be developed further to reduce side effects
• EFFECTIVENESS - conclusions

  effective if people stay on it

  may replace on addictive behaviour with another
• ETHICAL - valid consent

  when first diagnosed / suffering from acute episode of schizophrenia (severe psychosis symptoms) > may - detained and give antipsychotics without consent

  person with psychotic illness may not have the mental capacity to give consent to take meds > may lack understanding of taking it and possible side effects

  but - necessary to avoid harm from symptoms
• ETHICAL - chemical straightjacket

  Thomas Szasz - psychiatrist who argued against use of meds to treat psychological disorders

  - said antipsychotics aren't therapeutic - way of keeping troublesome people under control, therefore no different to straightjackets

  labelling people as mentally ill and using drugs to subdue them > way of excluding them from society - rather - helping them lead a positive life
• ETHICAL - serious side effects and risk of harm

  AP - headaches, nausea, weight gain

  - tardive dyskinesia - uncontrollable face movements > affects 30% and in 75% of these = irreversible

  - agranulocytosis - serious condition = decrease in number of a type of white blood cell in blood, due to immune response to narcotic/chemical > has lethal effect
• ETHICAL - serious side effects and risk of harm

  AGONIST - methadone = respiratory and stomach issues

  ANTAGONIST - naltrexone = affect liver function

  AG + ANTAG = increased risk of OD, especially when combined with other drugs

  phys harm > long term/serious health issues, serious risks but worth it to reduce suffering
• ETHICAL - conclusion

  costs vs benefits

  chemical straightjacket

  risk of harm

  valid consent not gained