Download Drug therapy - Beauchamp Psychology

DRUG THERAPY
EFFECTIVENESS – conventional
antipsychotics
• Effectiveness of antipsychotic medication can
be measured by comparing the relapse rates
of those on the drug, to those on a placebo.
• Davis et al (1980) analysed 29 studies. They
found that 55% of patients whose drugs were
replaced with a placebo relapsed, compared
to 19% of those who remained on the drug.
• This therefore shows the therapeutic effect of
traditional antipsychotics, although….
• The effectiveness of neuroleptics is only
for the positive symptoms not the
negative ones. i.e.
• Therefore....
EFFECTIVENESS – atypical
antipsychotics
• These are generally of comparable
overall effectiveness to the conventional
drugs.
• However they have fewer side effects,
and are more useful in helping
schizophrenia patients suffering mainly
with negative symptoms (Remington &
Kapur, 2000).
EFFECTIVENESS – in general
• Drug therapy has proved itself to be probably
more effective than any other form of therapy
in treating sz
• It often reduces the symptoms of sz more
rapidly than psychological therapies
• However, drug therapy is a palliative
treatment – it suppresses the symptoms
without addressing the underlying processes
(curative treatment) therefore symptoms
often return when treatment stops.
• Drugs are not effective for everyone
diagnosed with sz.
• Approx 30% either do not respond to
antipsychotic drugs or are intolerant to
them.
• This means they are limited in their
usefulness.
APPROPRIATENESS – conventional
antipsychotics
• More than 20% of patients who take
neuroleptic drugs for over a year
develop tardive dyskinesia.
• These symptoms include involuntary
sucking and chewing, jerky movements
of the limbs, and writhing movements of
the mouth or face.
• These effects can be permanent (in
75% of cases, Hill, 1986).
• This raises ethical issues. Critics argue
cost-benefit analysis would be negative.
APPROPRIATENESS – atypical
antipsychotics
• There is a lower likelihood of tardive
dyskinesia. This claim was supported
by Jeste et al. (1999), who found rates
in 30% of people after nine months of
treatment with conventional
antipsychotics, but only 5% treated with
atypical ones.
• Since there are fewer side effects, this
means patients are more likely to
continue their medications and
therefore see more benefits.
• However, even 15% of patients do not
respond to the atypical antipsychotic
drugs, therefore drug therapy at all is
not appropriate for some individuals.
• Also, there are issues with some other
serious side effects. e.g.
Agranulocytosis....
• Extension: research what this is
APPROPRIATENESS – in general
• Drug therapy is appropriate in that sz has
more of a genetic and biological basis than
almost any other mental disorder. This is a
good reason for assuming that drug therapy
might be especially appropriate.
• However, side effects mean patients may be
reluctant to take their medication.
Unfortunately this means that in some cases
there are tragic results