There are four main categories of prescribed drugs, anti-anxiety, anti-depressant, anti-manic and anti-psychotic. The later Anti-psychotic drugs, major tranquillisers and neuroleptic drugs reduce concentration and frequency of hallucinations and delusions however they are not a cure. These drugs reduce psychotic symptoms but can also produce some of the symptoms of neurological diseases. They decrease the positive symptoms of schizophrenia but have little effect on the negative symptoms. Anti-psychotic drugs are thought to work by either preventing the release of dopamine in pre-synaptic neurons or by binding with receptor sites on post-synaptic neurons. As how the drugs work cannot be fully explained there are doubts as to whether it is right for them to be used to treat patients. However anti-psychotic drugs greatly reduced the institutionalisation, enabling many schizophrenics to be cared for in the community. Though, around 25% of schizophrenics do not improve on traditional neuroleptics.
Another frequently used drug is clozapine, which is a neuroleptic drug that seems to have fewer side-effects than some others. Though, as Kendall and Hammen have highlighted it has two major limitations. Firstly, it is far more expensive compared to other drugs for schizophrenia and therefore there is restricted availability. Second, it can produce a potentially fatal blood disease in 1-2% of schizophrenic patients. Still the drug can have dramatic effects, causing formerly chronic unresponsive patients to ‘wake up’ from there psychotic states to go on and lead normal lives.
Treatment of schizophrenia by anti-psychotic drugs does not eliminate all schizophrenic symptoms. The anti-psychotic drugs merely reduce the symptoms in schizophrenic patients, and cannot be regarded as providing a cure for the mental disorder. But as no cause has been determined for schizophrenia devising a cure would be near to impossible. Still they are an illustration of the reductionist approach to treatment; by their use the real cause may be ignored. There are also serious side effects in a number of patients ranging from symptoms similar to those of Parkinson’s disease and tardive dyskinesia in 15-20% of patients. To grogginess, sedation, difficulty concentrating, dry mouth and blurred vision.
The use of drug therapy to treat schizophrenics carries the immense advantage that patients no longer need to be restrained in straight jackets. Nevertheless, they also have several unfortunate side effects and merely reduce symptoms rather than providing a cure for schizophrenia. The ethical issue of compulsory medication is raised. The drugs provide obvious advantages for the carers and families of schizophrenics. But whether, that means patients should be given medication without there consent is an ethical dilemma.
