Discuss the Main Treatments for Schizophrenia

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Treatments for Schizophrenia

The use of drugs or psychotherapies can be used in order to treat schizophrenia. If the causes of schizophrenia are physiological then it follows that treatments should be physiological. However it has been shown that both physiological and psychological factors can lead to the condition of schizophrenia, so it makes sense to consider both forms of treatment. Physiological treatments appear to fail not because they are ineffective but because patients often dislike the side effects of drugs and therefore don’t take them. As a result, psychological treatments (psychotherapies) are frequently used as an alternative to physiological treatments, or in addition to them.


Chemotherapy- Anti Psychotic Drugs

There are two main categories of drugs-

  1. Conventional Neuroleptic Drugs/ Anti Psychotic Drugs
  2. Newer Atypical Drugs

Conventional Anti Psychotic Drugs (such as Thorazine, Prolixin, Haldol and Chlorpromazine)

Conventional anti psychotic drugs are used to combat the positive symptoms such as hallucinations and thought disturbances. The positive symptoms are thought to be products of an overactive dopamine system. Conventional antipsychotics reduce dopamine levels. They are dopamine antagonists in that they bind to, but do not stimulate dopamine receptors, therefore blocking their action. In other words, they block the activity of the neurotransmitter dopamine, and this happens within 24 hours of taking the drug. However, it can actually take several weeks of drug therapy before schizophrenic symptoms show substantial reduction.

But do they really work?

COMER (2000) argues that neuroleptics reduces schizophrenic symptoms in the majority of patients and appear to be more effective treatment for schizophrenia than any of the other approaches alone.  He also suggests that neuroleptics tend to have their strongest benefit in the first 6 months. However even though COMER suggested that they were the most effective treatment it has been shown that there can be serious problems if patients with schizophrenia stop taking the drugs at any point, even after several years.

DAVIS ET AL. (1980) also researched into the effectiveness of antipsychotic drugs. They analysed the results of 29 studies (meta-analysis which included 3519 people in total) and found that relapse occurred in 55% of the patients whose drugs were replaced by a placebo, but relapses was significantly less (19%) in those who remained on the drug. However, ROSS & READ (2004) point out that these figures are misleading, because they also show that 45% of those who were given a placebo had no relapse, i.e. a significant number did just as well with the placebo therapy.

The advantages of meta-analysis include more reliable conclusions to be drawn, studies often produce rather contradictory results, for example some studies may find no effects, and some studies may find small effects while other studies find a larger effect. Therefore a meta-analysis allows us to reach and overall conclusion. On the flip side the disadvantage is the research designs in the different studies sampled may vary considerably which means that the studies are not truly comparable and therefore the conclusions may not always be valid.

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Also, on a negative side of the treatment as stated above, neuroleptic drugs do have side effects.

 WINDGASSEN (1992) found that 50% of patients reported grogginess or sedation, 18% reported problems with concentration and 16% had blurred vision. In addition, many patients develop symptoms closely resembling Parkinson’s disease (e.g. muscle rigidity, tremors and foot shuffling).  Approximately 2% of patients (mainly elderly ones) develop neuroleptic malignant syndrome (muscle rigidity, altered consciousness, fever, fatality). Drug treatment is halted as soon as the development of the condition is suspected. Most side effects occur within a few weeks of the start of ...

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