Biological therapies

• Atypical antipsychotics

  • used since 1970s due to decreased side effects
  • reduces both positive and negative symptoms
• Atypical

  • clozapine
  • initially developed and then withdrawn due to death of patient but then relaunched as a treatment when all others failed due to agranulocytosis
  • clozapine binds to the dopamine receptors and also serotonin and glutamate receptors
  • helps improve mood and reduce symptoms of depression and anxiety
  • helps patients who are suicidal (30-50%)
• atypical

  • Risperidone - developed in 1990s thought to bind more strongly to dopamine and serotonin receptors and therefore smaller doses can be used reducing side effects
• Typical antipsychotic

  • Chlorpromazine
  • taken as a syrup or injection
  • no longer usually prescribed due to the side effects
  • they work as dopamine an antagonist and reduce the effect of dopamine in the brain by blocking dopamine receptors in the brain by blocking D2 receptors.
  • sedates patients
• • large body of evidence to show the effectiveness of both typical and atypical antipsychotics.
  • Meltzer (2012) showed that Clozapine is more effective than typical antipsychotics and other atypical antipsychotics and is effective in 30-50% of treatment resistant cases where other have failed.
  • we can conclude for some patients the atypical anti-psychotics seems to work better for some patients but there individual differences in the way that people react to different drugs, linking back to the idea of different types of SZ
• • use of antipsychotic treatment = based upon assumption that high levels of dopamine in the subcortex are associated with the symptoms of SZ
  • evidence to show this assumption is not a complete explanation of SZ and that it may b caused by low levels of dopamine.
  • therefore it is not clear how using dopamine antagonists help with the symptoms when they reduce dopamine activity
  • demonstrates we don’t have a clear picture on the cause of SZ and the relationship between dopamine and psychosis - more research needed
• • may be bias in studies which support effectiveness of SZ
  • Healy (2012) suggests effectiveness may be due to their calming effect and this is not the same as reducing the severity of psychosis.
  • BUT it is widely believed that antipsychotics are used in a hospitals to calm patients = easier to handle, rather than it reducing the symptoms for the patients. This can be seen as human rights abuse (Moncheiff 2013) as they can be chemical straight jackets.
  • assessing effectiveness may be more difficult to assess and more studies are needed due to the way the studies are conducted.