Describe and Evaluate Biological Treatments for Schizophrenia

TREATMENT FOR SCHIZOPHRENIA

Historically people suffering from mental health issues were not treated with dignity or respect.

Before the 1950s schizophrenia was considered untreatable and patients were interned in mental institutions

Over time there have been a variety of different methods used to treat schizophrenia

• Rosenhan & Seligman vividly explain the back wards of mental hospitals as ‘snake pits’, filled with inmates who were unreachable or mutely catatonic, or were wild with delusions and straitjacketed.

• Attempts to treat schizophrenia with insulin, ECT and drugs often failed.

Chemotherapy• Since the 1950s use of drugs to

treat mental disorders has become widespread

• Types of drugs fall into following categories– Anti-anxiety– Anti-depressant– Anti-psychotic– Anti-manic– Stimulants

•They work to either increase or reduce the levels of various neurotransmitters

Group poster activityLets remind ourselves of the Dopamine Hypothesis:

Use this poster to propose how you could design a

Drug Therapy

DISCOVERY

1. In the mid 1950s it was discovered that large daily doses of Amphetamines could produce a psychosis identical to schizophrenia

• Amphetamine increases D2 transmission

2. Chlorpromazine improves symptoms of schizophrenia

• Prevents Dopamine from activating

• This knowledge has led to the development of drugs that have similar pharmacological properties to chlorpromazine.

• The symptoms that are most responsive to these types of drugs are the ‘positive’ symptoms. Type 1

• Anti-psychotic drugs have provided a breakthrough in treating schizophrenia and remain the main form of treatment

– Although they provide a calming effect…..The problem is ……– Have little effect on Type 2– Have side effects

ANTIPSYCHOTIC DRUGS

2. Clozapine: blocks less dopamine and blocks more serotonin.

a. Reduces both positive and negative symptoms.

b. Fewer side effects; . c. Problem: produces a potentially lethal blood disorder.

1. Phenothiazines: decreases dopamine activity. a. Reduces positive

symptoms (hallucinations, delusions, etc.).

b. Fails to reduce negative symptoms (flat affect, low motivation, etc.).

c. Unpleasant side effects: dizziness, nausea, sexual impotence, tardive dyskinesia (involuntary facial movements), etc.

d. May cause permanent biochemical changes reducing possible eventual full recovery.

Group Activity

Make a drug marketing poster to describe the usefulness of your chosen drug.

You must include health warning / side effects information on your poster.

Using p111 of text book

Pickar (1992) Emsley (2008)

“Problem Schizophrenics”

• Newer generation antipsychotics can be effective in these normally unresponsive schizophrenics. They also lack some of the debilitating side effects of the older Drugs.

• These newer generation antipsychotics appear to block

multiple subtypes of dopamine receptors (including D1 D2 D3 D4 D5).

Evaluation of biological treatments