biological

• what is the main assumption of biological treatments

  schizophrenia has a physical cause, so the treatments used aim to address the physical cause
• what are the main treatments used under the biological treatment

  antipsychotic drugs, but in the past ECT and psychosurgery were both used
• what are the two types of antipsychotics?

  typical and atypical
• what do antipsychotics do?

  they reduce dopamine activity by blocking dopamine receptors. they are used to tackle the positive symptoms of schizophrenia. they can be administered as tablets, a syrup, injections, and now implants for patients who can't be trusted to take medication
• Typical antipsychotics

  e.g. chlorpromazine

  these work by blocking dopamine receptors so the number of messages and strength of the signal is reduced. these are known as antagonistics [chemicals that reduce neurotransmitter activity]
• atypical antipsychotics

  e.g. clozapine

  these are a newer form of antipsychotic. they affect serotonin and glutamate levels as well as levels of dopamine activity. these are more effective in handling negative symptoms.
• evaluation of antipsychotics

  + very effective for many schizophrenia sufferers and they work quickly

  + they can be used in first instance to calm patients down

  + they reduce positive symptoms so that patients are more receptive to psychological therapies

  + drugs are cheap and easy to administer and can reduce time spent in hospital
• evaluation of antipsychotic drugs


  
  

  • not all people with schizophrenia find them effective
  • side effects are sometimes so unpleasant that they refuse to take them
  • non-compliance in taking the drugs is high
  • relapse rates are high due to non-compliance [40% in the first year]
  • revolving door syndrome [released, stop medication, come back]
  • remove responsibility
  • ethical issues
• side effects of typical antipsychotics

  1. dry mouth
  2. constipation
  3. low blood pressure
  4. sexual function may be diminished
  5. weight gain
  6. long term use can cause tradive dyskinesia
• side effects of Atypical antipsychotics

  1. weight gain
  2. fatal blood disorder
  3. life threatening neurological disorder
  4. high fever
  5. coma
  6. sudden cardiac arrest
  7. stroke
  8. blood clots
  9. diabetes
  10. tremors
• Bagnall et al 


  compared both cost and clinical effectiveness, as well as safety, of typical and atypical antipsychotics. data was compiled from 171 randomly controlled trials and 52 non-randomised trials of the effectiveness of drug treatments on schizophrenia. data was also compared from 31 economic evaluations. it was found that atypical was more effective in reducing symptoms of schizophrenia. drop out rates wre fewer for those taking atypical antipsychotics. however atypical drugs were more expensive. it was also found that different drugs suite different patients better
• Lieberman et al


  examined the effectiveness of typical and atypical antipsychotics in treating 1432 individuals with chronic schizophrenia

  74% discontinued treatment within 18 months due to intolerable side effects. the rates of discontinuation were similar between both atypical and typical

  atypical discontinuation due to muscular disorders

  typical discontinuation due to metabolic effects and weight gain
• Schooler et al

  compared the effectiveness of typical and atypical antipsychotics and found that both are effective in treating schizophrenia

  75% of patients experienced at least a 20% decrease in symptoms

  55% of those recieving typical antipsychotics suffered relapses compared to 42% for those recieving atypical treatment
• Marder

  reported that the atypical antipsychotic clozapine is as effective as typical antipsychotics in relieving the positive symptoms of schizophrenia

  effective in approximately 30-61% if oatuebts who are resistant to typical antipsychotics
• Davis et al


  conducted a meta analysis of over 100 studies that compared antipsychotics with placebos, fidnings drugs to be more effective

  over 70% of those on antipsychotics improved in condition after 6 weeks compared to fewer than 25% improving on the placebo
• Pedersen

  found that cannabidol, an ingredient in marijuana that doesn't contain THC, worked as effectively as antipsychotics but with fewer side effects. suspicion is that its cheaper so drug companies won't produce it