Biological Therapies for Schizophrenia

• What was the frontline treatment for schizophrenia in the past?

  Electro-convulsive therapy (ECT)
• Why is electro-convulsive therapy no longer used for treating schizophrenia?

  Because early forms were brutal and showed only short-term or no improvement of symptoms
• What are the two types of drug therapy for schizophrenia?

  Typical and atypical antipsychotic drugs
• What neurotransmitter do typical antipsychotic drugs primarily target?

  Dopamine
• What neurotransmitters do atypical antipsychotic drugs target?

  Dopamine and serotonin
• What is the most common treatment for schizophrenia?

  Antipsychotic medication
• How do phenothiazines work in treating schizophrenia?


  By blocking dopamine receptors in the brain
• What percentage of patients experience a reduction in positive symptoms when treated with phenothiazines?

  60%
• What are some problems associated with phenothiazines?

  Parkinsonian symptoms, neuroleptic malignant syndrome, and tardive dyskinesia
• What is tardive dyskinesia?


  Involuntary writhing, lip smacking, chewing, and smacking that appears after long-term use
• What is clozapine and how does it differ from typical antipsychotics?


  Clozapine is an atypical antipsychotic that works on both serotonin and dopamine receptors
• What percentage of patients find clozapine useful in treating their symptoms?

  Up to 85%
• What additional benefits does clozapine provide beyond reducing symptoms?

  It helps improve mood and reduce depression and anxiety
• Why might clozapine be prescribed to patients at high risk of suicide?

  Because around 30-50% of patients attempt suicide at some point
• What is the risk associated with clozapine known as agranulocytosis?

  A life-threatening condition ‘Agranulocytosis’ (1% chance) causing a dramatic drop in white blood cell count
• Why is clozapine less widely available compared to other drugs?

  Because it is more expensive
• What are the main evaluations of drug therapy for schizophrenia?

  • Relapse: symptoms return when patients stop drugs
  • Treats symptoms only, indicating a chemical imbalance is part of the problem
  • Possible placebo effect
  • Compliance issues: some patients refuse or forget medication
  • Ethics: concerns about informed consent and side effects
  • Reductionist approach: excludes other helpful methods
• What is a potential solution to the compliance issue with medication for schizophrenia?

  Depot injections that release medication slowly over weeks