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• •Serotonin is released into a synapse from one nerve (neuron). It targets receptor cells on the initial neuron sending the message. In order to increase levels of serotonin at the synapse, and decrease OR increase stimulation to the receiving neuron, this re-absorption (re-uptake) is inhibited.

  •SSRIs block the re-uptake of serotonin at the pre OR post synaptic membrane, increasing serotonin concentration at receptor sites on the pre OR post synaptic membrane. 
• One strength of antipsychotic drugs is their effectiveness in reducing schizophrenia symptoms, particularly positive symptoms such as hallucinations and delusions. Typical antipsychotics, like chlorpromazine, work by blocking dopamine receptors (D2) in the mesolimbic pathway, reducing dopamine activity.
• Research evidence supports their efficacy—for example, Thornley et al. (2003) conducted a meta-analysis and found that chlorpromazine was significantly more effective than a placebo in reducing symptom severity and improving overall functioning. However, these drugs primarily target positive symptoms and may be less effective for negative symptoms such as avolition, which limits their usefulness for some patients.
• A major criticism of typical antipsychotics is the severity of side effects, which can significantly impact adherence to treatment. Because these drugs block dopamine receptors indiscriminately across the brain, they can cause extrapyramidal side effects such as tardive dyskinesia (involuntary facial movements) and Parkinsonism (tremors and rigidity). This raises ethical concerns, as some patients may feel coerced into taking medication despite these distressing effects.
• . Lieberman et al (2005) found that 74% of 1,342 schizophrenic patients discontinued antipsychotic drug treatment within 18 months due to side effects.
• Antipsychotics are dopamine antagonists because they bind to complementary dopamine receptors on the postsynaptic membrane, thus preventing dopamine molecules from binding to these sites. The result is an inhibitory effect, where there is a lower rate of action potential generation in the postsynaptic membranes, and so returns neurotransmission (e.g. in the prefrontal cortex and subcortices) to a normal level.
• Typical antipsychotics are cheaper to produce than newer atypical antipsychotics, making them widely available in healthcare systems, especially in countries with limited medical resources. Since schizophrenia often requires lifelong treatment, the affordability of typical antipsychotics ensures that a larger number of patients can receive treatment.
• However, while typical antipsychotics are cost-effective, the high risk of severe side effects (such as movement disorders) may outweigh the financial benefits for some patients. This raises ethical concerns about whether patients should be given older, riskier drugs simply because they are cheaper.
• Research suggests that patients who experience predominantly negative symptoms may not benefit as much from typical antipsychotics, and they are more likely to be prescribed atypical drugs like clozapine, which target both dopamine and serotonin.
•  This means that while typical antipsychotics are useful for some patients, they are not suitable for all schizophrenia cases. Atypical antipsychotics may be more effective for treating both positive and negative symptoms.
• One strength of typical antipsychotic drugs is that they have a long history of effectiveness in treating the positive symptoms of schizophrenia, such as hallucinations and delusions. For example, research has shown that Chlorpromazine works by blocking dopamine receptors, reducing dopamine activity, which is consistent with the dopamine hypothesis
• However, a major weakness is the severe side effects associated with typical antipsychotics. These can include dizziness, agitation, sleepiness, and more seriously, tardive dyskinesia – involuntary facial movements that are often irreversible. These side effects reduce the quality of life and can lead to patients discontinuing their medication, which undermines treatment effectiveness. Furthermore, they do little to help with negative symptoms, such as social withdrawal or avolition, limiting their overall usefulness.
• A strength of atypical antipsychotics is that they target a broader range of neurotransmitters, such as dopamine and serotonin, and have been found to be more effective in treating both positive and negative symptoms of schizophrenia. For example, Clozapine has shown superior efficacy, especially in treatment-resistant cases. Additionally, these drugs are generally associated with fewer extrapyramidal side effects, such as tardive dyskinesia, compared to typical antipsychotics, making them more tolerable for many patients.
• A key real-world benefit of using antipsychotic drugs is that they have made it possible for many individuals with schizophrenia to live relatively normal lives outside of institutional care. Before the introduction of effective medications in the 1950s, people with schizophrenia were often confined to psychiatric hospitals for long periods. With the use of drugs like chlorpromazine and clozapine, symptoms can be managed effectively, allowing individuals to engage in therapy, maintain employment, and live independently.
• This not only improves patients’ quality of life but also reduces the economic burden on healthcare systems through fewer hospital admissions. It shows how biological treatments have transformed mental health care by enabling community-based treatment
• the biological approach can be accused of reductionism as it oversimplifies schizophrenia by focusing solely on neurochemical imbalances and ignoring social, psychological, and environmental factors. This may lead to drug treatment being seen as a “quick fix,” which could undermine the value of psychological therapies such as CBT that address the root causes of distress and help patients develop long-term coping strategies.