TREATMENT AND MANAGEMENT OF SCHIZOPHRENIA
BIOLOGICAL TREATMENTS- BIOCHEMICAL TREATMENTS
(TYPICAL AND ATYPICAL ANTIPSYCHOTICS)
BIOCHEMICAL
biochemical treatments for schizophrenia includes the use of antipsychotics medications. These re typically
administered orally as syrups or tablets but can also be given transdermally(through the skin) in creams, gels,
patches and sprays (and also through needles).
TYPICAL ANTIPSYCHOTICS
Antipsychotic drugs are used to treat a range of mental disorders, including schizophrenia
(psychotic refers to any condition in which a person loses touch with reality)
Typical antipsychotics are also known as first-generation antipsychotics, as they have been in use since
the 1950s
Typical antipsychotics are dopamine antagonists, i.e., they inhibit dopamine activity by blocking dopamine
receptors in the synapse
Examples of typical antipsychotics include chlorpromazine, trifluoperazine,
acetophenazine and haloperidol
Typical antipsychotics are effective at treating the positive symptoms of schizophrenia e.g. delusions
Haloperidol and chlorpromazine come with side effects, some of which are quite severe, e.g.,
drowsiness, agitation, dry mouth, blurred vision, lack of emotional response, dizziness, muscle stiffness or
spasms
Over-use of typical antipsychotics may lead to tardive dyskinesia (sensitivity to dopamine) or neuroleptic
malignant syndrome (a result of dopamine being blocked in the thalamus), which can be life threatening.
ATYPICAL ANTIPSYCHOTICS
Atypical antipsychotics are second-generation antipsychotics developed in the 1980s as a solution to
the potentially damaging side effects of typical antipsychotics
Atypical antipsychotics are dopamine antagonists, i.e., they inhibit dopamine activity by blocking
dopamine receptors in the synapse but they may act as serotonin agonists, i.e., they inhibit
serotonin reuptake in the synapse
Atypical antipsychotics treat both the positive and negative symptoms of schizophrenia
Examples of atypical antipsychotics include risperidone, olanzapine, brexpiprazole, and clozapine
Clozapine is prescribed when other antipsychotic drugs have not worked; it also helps to reduce
tardive dyskinesia
Clozapine may act on serotonin receptors, which can help to balance mood
, Risperidone is thought to act in the same way as antidepressants.
RESEARCH WHICH INVESTIGATES DRUG THERAPIES
Marder & Meibach (1994) - Schizophrenic patients who took risperidone compared to haloperidol or
a placebo showed significant improvement in both positive and negative symptoms
Geddes et al. (2000) conducted a review of research and found that there is no real difference in terms
of effectiveness between first- and second-generation antipsychotics: typical antipsychotics should be
prescribed in the early stages of an episode of schizophrenia unless the patient has previously had
side-effects which included disjointed movement, including muscles spasms
EVALUATION OF DRUG THERAPIES IN A LEVEL PSYCHOLOGY
Strengths
There is a body of compelling research evidence which suggests that antipsychotics are an effective
treatment for schizophrenia. A meta-analysis conducted by Zhao et al in 2016 portray how drug
therapy can be used as an alternative for hospitalization, which was the only effective for of therapy
before the development of drugs such as chlorpromazine.
Antipsychotics are most effective at treating patients with the most severe symptoms who may not be
treatable using non-drug therapies (Furakawa et al. 2015)
Limitations
Patients with milder, less extreme forms of schizophrenia benefit less from taking antipsychotics and
may additionally experience adverse side effects
It is not clear as to how effective antipsychotics are in preventing relapses in patients who are
in remission
While medication may prevent hospitalization, the side effects can be unpleasant and fatal. dizziness,
drowsiness, restlessness, nausea, constipation and weight fluctuations are common side effects
caused by antipsychotic medication.
Typical antipsychotics often lead to tardive dyskinesia, characterized by uncontrollable blinking, jerking
and twitching of the face and the body.
Atypical antipsychotics have fewer side effects in comparison but can cause serious issues, for
example, clozapine can cause agranulocytosis, a potentially fatal blood condition (the risk can be
minimized through regular blood counts).
Drug therapy is ineffective for 30%-70% of people (Howes et al, 2017). Efficacy decreases the longer
the start of the treatment is delayed, and the greatest gains are made within the first five years.
60-80% of people relapse unless they continue to take a maintenance dose of their medication
according to the study conducted by Patel et al in 2014.
BIOLOGICAL TREATMENTS- BIOCHEMICAL TREATMENTS
(TYPICAL AND ATYPICAL ANTIPSYCHOTICS)
BIOCHEMICAL
biochemical treatments for schizophrenia includes the use of antipsychotics medications. These re typically
administered orally as syrups or tablets but can also be given transdermally(through the skin) in creams, gels,
patches and sprays (and also through needles).
TYPICAL ANTIPSYCHOTICS
Antipsychotic drugs are used to treat a range of mental disorders, including schizophrenia
(psychotic refers to any condition in which a person loses touch with reality)
Typical antipsychotics are also known as first-generation antipsychotics, as they have been in use since
the 1950s
Typical antipsychotics are dopamine antagonists, i.e., they inhibit dopamine activity by blocking dopamine
receptors in the synapse
Examples of typical antipsychotics include chlorpromazine, trifluoperazine,
acetophenazine and haloperidol
Typical antipsychotics are effective at treating the positive symptoms of schizophrenia e.g. delusions
Haloperidol and chlorpromazine come with side effects, some of which are quite severe, e.g.,
drowsiness, agitation, dry mouth, blurred vision, lack of emotional response, dizziness, muscle stiffness or
spasms
Over-use of typical antipsychotics may lead to tardive dyskinesia (sensitivity to dopamine) or neuroleptic
malignant syndrome (a result of dopamine being blocked in the thalamus), which can be life threatening.
ATYPICAL ANTIPSYCHOTICS
Atypical antipsychotics are second-generation antipsychotics developed in the 1980s as a solution to
the potentially damaging side effects of typical antipsychotics
Atypical antipsychotics are dopamine antagonists, i.e., they inhibit dopamine activity by blocking
dopamine receptors in the synapse but they may act as serotonin agonists, i.e., they inhibit
serotonin reuptake in the synapse
Atypical antipsychotics treat both the positive and negative symptoms of schizophrenia
Examples of atypical antipsychotics include risperidone, olanzapine, brexpiprazole, and clozapine
Clozapine is prescribed when other antipsychotic drugs have not worked; it also helps to reduce
tardive dyskinesia
Clozapine may act on serotonin receptors, which can help to balance mood
, Risperidone is thought to act in the same way as antidepressants.
RESEARCH WHICH INVESTIGATES DRUG THERAPIES
Marder & Meibach (1994) - Schizophrenic patients who took risperidone compared to haloperidol or
a placebo showed significant improvement in both positive and negative symptoms
Geddes et al. (2000) conducted a review of research and found that there is no real difference in terms
of effectiveness between first- and second-generation antipsychotics: typical antipsychotics should be
prescribed in the early stages of an episode of schizophrenia unless the patient has previously had
side-effects which included disjointed movement, including muscles spasms
EVALUATION OF DRUG THERAPIES IN A LEVEL PSYCHOLOGY
Strengths
There is a body of compelling research evidence which suggests that antipsychotics are an effective
treatment for schizophrenia. A meta-analysis conducted by Zhao et al in 2016 portray how drug
therapy can be used as an alternative for hospitalization, which was the only effective for of therapy
before the development of drugs such as chlorpromazine.
Antipsychotics are most effective at treating patients with the most severe symptoms who may not be
treatable using non-drug therapies (Furakawa et al. 2015)
Limitations
Patients with milder, less extreme forms of schizophrenia benefit less from taking antipsychotics and
may additionally experience adverse side effects
It is not clear as to how effective antipsychotics are in preventing relapses in patients who are
in remission
While medication may prevent hospitalization, the side effects can be unpleasant and fatal. dizziness,
drowsiness, restlessness, nausea, constipation and weight fluctuations are common side effects
caused by antipsychotic medication.
Typical antipsychotics often lead to tardive dyskinesia, characterized by uncontrollable blinking, jerking
and twitching of the face and the body.
Atypical antipsychotics have fewer side effects in comparison but can cause serious issues, for
example, clozapine can cause agranulocytosis, a potentially fatal blood condition (the risk can be
minimized through regular blood counts).
Drug therapy is ineffective for 30%-70% of people (Howes et al, 2017). Efficacy decreases the longer
the start of the treatment is delayed, and the greatest gains are made within the first five years.
60-80% of people relapse unless they continue to take a maintenance dose of their medication
according to the study conducted by Patel et al in 2014.
