Biological Therapies (20)

• intro: If schizophrenia is caused by an excess or deficiency of a neurochemical, it suggests that treatment should be biological; antipsychotic medication helps to alleviate symptoms such as delusions or hallucinations.
• 1; AO1:

  • Antipsychotic drugs first developed in the 1950s, known as ‘typical’ antipsychotics. These drugs target excess dopamine by blocking receptors,
  •  eg chlorpromazine which prevents dopamine overreactivity, providing long term management in improving positive symptoms such as hallucinations/delusions.
• 1; AO3:

  •  strength: Meltzer et al carried out studies looking at effectiveness of drug treatments in schizophrenia. 148 patients with schizophrenia were randomly assigned to groups for 6 weeks; 4 new psychotic drugs, haloperidol (an established antipsychotic) and a placebo. Haloperidol gave significant improvements compared with placebo. 2 of the new drugs showed improvements compared with placebo but 2 did not.
• 1; AO3:

  •  strength: fewer people end up institutionalised, first generation drugs successfully reduced positive symptoms for 60% of people, this improves their quality of life and allows them to function/carry out everyday tasks, suggesting that drug therapies are an effective form of treatment.
• 2; AO1:

  •  Second generation antipsychotics developed in the 1990s, known as ‘atypical.’ They target dopamine and other neurotransmitters such as serotonin & glutamate by blocking receptors.
  •  They temporarily bind with D2 and then disappear, leaving normal functioning.
  •  eg clozapine which is effective for both positive and negative symptoms, so is sometimes used for treatment resistant clients. Clozapine is one of the most effective antipsychotic drugs with fewer side effects.
• 2; AO3:

  •  strength: McEvoy et al compared discontinuation times with 4 atypical drugs in patients who found a different atypical drug to not be working, most effective drug was clozapine as patients continued taking this for a longer period of time. Clozapine was also most effective in terms of symptom assessment after 3 months of treatment.
• 2; AO3:

  •  weakness: treat the symptoms rather than the cause, symptoms will return once the treatment stops; for example, relapse occurs in 60-80% of those who do not maintain their dose. Therefore, this means that patients will be constantly discharged and readmitted, which is known as the revolving door phenomenon
• 3; AO1: Side effects

  •  In the first seven days following a psychotic episode, the objective is to decrease hostility & attempt to return the client to normal functioning.
  •  They are carefully monitored for changes in symptoms and side effects.
  •  Most people will experience some short term side effects such as drowsiness, blurred vision, constipation
• 3; AO1:

  •  Eg of side effects in FGAs is parkinson's symptoms such as shaking & lack of motorcontrol. Tardive dyskinesia is involuntary movement of the lips and tongue; 30% of people experience this, and 75% of those have an irreversible case. An example of side effects in SGDs is that 2% of people develop agranulocytosis; a potentially fatal blood disorder, meaning they require regular blood tests.
• 3;AO3:

  • weakness: patients can lack compliance or stop taking medication due to the negative side effects, for example, Lieberman et al found that many patients stop taking medication because of severe side effects which have serious consequences for treatment effectiveness.
  •  weakness: Patel found that 45% of people with schizophrenia experienced only partial improvement & unacceptable side effects after FGD trials, this demonstrates how the cost of side effects can prevent someone accepting treatment and getting better, suggesting that biological therapies are not effective
• 3;AO3:

  •  strength: Jeste et al found that 30% of a sample developed tardive dyskinesia after 9 months on FGD compared to 5% on SGD.
• 4;AO1:

  •  drugs may be a ‘chemical straight jacket’ and do not actually help the patient, which makes treatment a form of social control.
  •  Ross and Read state that prescribed drugs reinforce that there is something wrong with you, preventing the person from thinking about other possible stressors which could trigger the condition.
  • mask symptoms and reduce them only to improve society & the safety of themselves/others rather than allowing them to understand how to deal with symptoms. This means that as soon as an individual stops taking medication, the symptoms will return as they were.
• 4; AO3:

  •  weakness: Leucht et al carried out a meta analysis on 65 studies, involving 6000 patients who had been stabilised on antipsychotics. Some were taken off the medication and given a placebo instead. Within 12 months, 64% on placebo had relapsed compared to 27% who remained on medication. This shows the effectiveness of treatment.
• 4;AO3:

  •  weakness: substance abuse can affect effectiveness, amphetamines, caffeine, alcohol and nicotine can disrupt the effectiveness of antipsychotic medications. Therefore support for substance abuse should be considered when treating someone with antipsychotics.
• application: There is a strong raft of empirical evidence to support the use of dopamine related drug treatments of schizophrenia. For example, studies have been well controlled & are objective, placebo groups have been used for comparison in double blind studies with humans and animal experiments have removed problems associated with confounding variables that relate to course of disorder pre diagnosis. Therefore, findings are applicable, suggesting that biological therapies can successfully treat schizophrenia.
• alternative: An alternate theory is the diathesis stress model. This suggests that schizophrenia is a combination of biological and environmental factors. Environmental factors are thought to act as a trigger for biological dispositions; an increased D2 receptor.Therefore, this concludes that biological therapies are an effective treatment for schizophrenia but should be monitored closely and given alongside other psychological therapies in order to successfully reduce symptoms long term.