Discuss two or more biological therapies for schizophrenia

The differing ways in which the drugs work is central to the argument over whether either is effective or appropriate. Davis et al. (1980) studied the influence of conventional antipsychotics against a placebo and found significant difference in terms of relapse rates, suggesting therapeutic effectiveness. However a more recent analysis of that study by Ross and Read has suggested that its results were misleading: as all those studied, including those who took placebos, were on antipsychotics before the study began, it was, rather than a study comparing treatment to non-treatment, a comparison between continued treatment and withdrawn treatment. Ross and Read suggest a significant proportion of the relapses in the placebo group can be explained by these withdrawal symptoms, leaving the conclusions drawn by Davis thirty years ago discredited. In terms of appropriateness, critics have also pointed to the development of tardive dyskinesia – uncontrollable movements of the lips, tongue, face, hands and feet - in 30% of patients taking conventional antipsychotics, with only 25% of these cases treatable. Some suggest that, given this side effect administration of these drugs is unethical, and defies articles regarding harmless treatment in the Human Rights Act 1988.

By contrast, only 5% of those treated with atypical antipsychotics are thought to develop tardive dyskinesia – research would suggest that this is the key strength of atypical drugs, as fewer side effects encourage patients to continue taking medication and therefore seeing more benefits. However, other claims such as their reduction of negative symptoms and superiority over conventional alternatives find less support. In fact, studies by Leucht have concluded that half of all atypical drugs are only ‘slightly’ more effective than conventional ones, with the other half no more effective, or even worse.

The alternative to drugs of any kind can be found in ECT, an idea suggested by 1950s reports that patients with severe epilepsy were highly unlikely to ever suffer from schizophrenic symptoms; prompting the suggestion that inducing seizures in patients with these symptoms could have a positive effect. The modern process involves the passing of a 0.6 amps of electric current, for half a second, through the brain of a patient who has been injected with both a short-acting barbiturate and nerve-blocking agent to protect from pain and possible fracturing. This produces a seizure lasting around a minute, affecting the entire brain; though exactly how or why this effect occurs is still unknown. Whilst a Tharyan and Adams study found that ECT is more effective than a placebo treatment, it is at best only equal to treatment on a course of medication; there was some limited evidence to suggest an ECT-drug combination may be the optimum way to deal with the disorder, but ultimately the debate over use of the treatment still rages. This said it would appear as though its critics are winning: between 1979 and 1999, the decline in UK cases of ECT treatment was 59%, most likely due to studies such as those by Read which have found memory dysfunction, brain damage and even death as side effects of the procedure.