Download the Biological Treatment for Schizophrenia

Drug Therapy
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Although the causes of schizophrenia are still largely
unknown, treatment for it focuses on lessening the
type one and type two symptoms that can cause so
much distress and dysfunction in the life of a
schizophrenic.
So the first line of schizophrenia therapy is
medication to treat the psychotic symptoms.
There are five types of drugs:
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Anti-anxiety
Anti-depressants
Anti-psychotics
Anti-manic
Stimulant
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Once someone with schizophrenia is stabilized on
medication, psychosocial therapy can help him or
her learn to cope with this illness and live as
independently as possible.
Older antipsychotic drugs, such as
chlorpromazine, typically affect dopamine levels,
and have many unpleasant side effects that
cause muscle spasms and tremors.
Newer drugs, such as Clozapine, are usually more
refined and are much safer with fewer unwanted
side effects — although the effects that remain
can still have a big impact on quality of life.
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Atypical drug → Less common/More specialised
Blocks both Dopamine and Serotonin receptor
sites
Fewer side effects than typical drugs
Similar side effects to typical drugs:
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Muscle stiffness
Weight gain
Restlessness
Rare side effects:
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Agrnulocytosis (dangerously low levels of white blood
cells) which can be fatal
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One of the main strengths is that the patient is
able to live in society, thus avoiding
institutionalisation which can occur from a long
period of time in hospital.
Also the ability to remain in
society gives the patient
access to other therapies,
which may improve the
recovery process.
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Emsley (2008) studied the effect of injecting the
antipsychotic drug risperidone. He found that those
who had the injection early in the course of their
disorder had high remission rates (64%) and low
relapse rates.
Picklar et al. (1992) compared the effectiveness of
clozapine with other neuroleptics and a placebo drug.
He found that clozapine was the most effective in
treating symptoms, even in patients who did not
respond to previous drugs, the placebo was the least
effective.
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A large barrier to treating schizophrenia is non or
partial compliance to taking the drugs. These can
lead to relapses and readmittance to hospital.
The more relapses in a patient, the higher risk of
never getting back to their original functioning
state.
Rosa et al. found that approximately 50% of
patients comply with their drug therapy, and even
if they do comply it was found that 50% still have
distressing symptoms
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A negative with all drugs is the side effects that
can occur; e.g. sedation, weight gain, decrease in
emotional motivation: these in many cases can be
enough to put people off taking them.
Drug treatments cannot be seen as a cure, as
patients have to be kept on maintenance doses of
the drug to maintain the therapeutic effect.
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Social control is a formal way of making
individuals conform to society’s rules.
Drug therapy can be considered a form of social
control as they are used to help make patients
behave more ‘normally’, according to the society’s
social norms.
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As identified, compliance rates are low which
leads to increased relapse rates, and the fact that
anti-psychotics only treat symptoms and not the
causes may mean drug therapy is not an effective
means of controlling abnormal behaviour.
It is, however, relatively cost-effective to society,
allowing behaviour to be controlled away from the
institution setting.
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Anti-psychotic drugs can have many distressing
and possibly painful side-effects, which the
patient is not protected from.
The patient can become addicted to and
dependent on the drug prescribed, which limits
the control they have over the treatment process.
Both of these points mean informed
consent must be gained.
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The key ethical issue with drug therapy is determining
whether the patient has the mental capacity to give
informed consent. According to the Mental Capacity
Act, 2005, this is decided by the health professional
in charge of the patient’s case.
This means that the patient’s control over their
situation is taken from them, and they may be forced
to continue the treatment against their wishes.
Should practitioners have this power over patients?