PAPER THREE: SCHIZOPHRENIA
TOPIC: Biological treatments: Schizophrenia
A01:
Antipsychotics = drugs used to reduce the intensity of symptoms of psychotic conditions like
SZ
Can be divided into:
Typical antipsychotics = the first generation of antipsychotic drugs, work as dopamine
antagonists
Atypical antipsychotics = drugs for SZ developed after typical antipsychotics, work on a
range of neurotransmitters
- Can be taken as tablets, syrup, injections
- Don’t cure SZ but can reduce the symptoms so a degree of normal functioning can
occur
TYPICAL: CHLORPROMAZINE
- Daily dosage = 400, 800, 1000 mg
- Act as antagonists in the dopamine system
- Block dopamine receptors in the synapses of the brain
- Normalises neurotransmission in areas of the brain, reducing symptoms like
hallucinations
- Also an effective sedative and often used to calm people
SIDE EFFECTS:
- Tardive dyskinesia = caused by dopamine super sensitivity and manifests as
involuntary facial movements (grimacing)
- Neuroleptic malignant syndrome = drug blocks dopamine action in the hypothalamus
and results in high temperature, disorientation, coma
ATYPICAL: CLOZAPINE
- Daily dosage = 300 - 450mg
- Withdrawn temporarily following the deaths of some users from a blood condition
(agranulocytosis)
- Binds to dopamine receptors but also acts on serotonin and glutamate receptors
- This helps improve mood and reduce depression
- Sometimes prescribed when a person is considered at high risk of suicide
SIDE EFFECTS:
- Less side effects than typical antipsychotics
- Weight gain
- High fever
- Unstable blood pressure
ATYPICAL: RISPERIDONE
- Developed in an attempt to produce a drug as effective as Clozapine but without its
serious side effects
- Binds to dopamine and serotonin receptors, but binds more strongly to dopamine
receptors than Clozapine
- Effective in much smaller doses than most antipsychotics
A03:
✓ - Evidence to support typical antipsychotics
, Thorny et al, reviewed data from 13 trials and found that Chlorpromazine was associated
with better functioning and reduced symptom severity compared with a placebo
Suggests typical antipsychotics are beneficial as they have been found to be effective in the
treatment of SZ
Problem = typical antipsychotics have side effects which range from mild to fatal and can
result in the onset of further life altering disorders
✓ - Support for effectiveness of atypical antipsychotics
Meltzer et al, concluded that Clozapine is more effective than typical antipsychotics and it is
30-50% more effective in treatment-resistant cases
Suggests atypical antipsychotics are beneficial for patients with SZ
X - Suggested the evidence to support the effectiveness of antipsychotics is exaggerated
Healy et al, some successful trials have been published multiple times exaggerating positive
effects
Most studies also only review short-term effects
Overestimates the effectiveness of antipsychotics
X - Dopamine theory (premise of using antipsychotics is based on) has flaws
Evidence that dopamine levels in other parts of the brain are too low rather than too high
meaning antipsychotics shouldn’t work
Even though atypical psychotics have been successful in eradicating most side effects, they
do still exist and therefore remain a weakness
TOPIC: Biological treatments: Schizophrenia
A01:
Antipsychotics = drugs used to reduce the intensity of symptoms of psychotic conditions like
SZ
Can be divided into:
Typical antipsychotics = the first generation of antipsychotic drugs, work as dopamine
antagonists
Atypical antipsychotics = drugs for SZ developed after typical antipsychotics, work on a
range of neurotransmitters
- Can be taken as tablets, syrup, injections
- Don’t cure SZ but can reduce the symptoms so a degree of normal functioning can
occur
TYPICAL: CHLORPROMAZINE
- Daily dosage = 400, 800, 1000 mg
- Act as antagonists in the dopamine system
- Block dopamine receptors in the synapses of the brain
- Normalises neurotransmission in areas of the brain, reducing symptoms like
hallucinations
- Also an effective sedative and often used to calm people
SIDE EFFECTS:
- Tardive dyskinesia = caused by dopamine super sensitivity and manifests as
involuntary facial movements (grimacing)
- Neuroleptic malignant syndrome = drug blocks dopamine action in the hypothalamus
and results in high temperature, disorientation, coma
ATYPICAL: CLOZAPINE
- Daily dosage = 300 - 450mg
- Withdrawn temporarily following the deaths of some users from a blood condition
(agranulocytosis)
- Binds to dopamine receptors but also acts on serotonin and glutamate receptors
- This helps improve mood and reduce depression
- Sometimes prescribed when a person is considered at high risk of suicide
SIDE EFFECTS:
- Less side effects than typical antipsychotics
- Weight gain
- High fever
- Unstable blood pressure
ATYPICAL: RISPERIDONE
- Developed in an attempt to produce a drug as effective as Clozapine but without its
serious side effects
- Binds to dopamine and serotonin receptors, but binds more strongly to dopamine
receptors than Clozapine
- Effective in much smaller doses than most antipsychotics
A03:
✓ - Evidence to support typical antipsychotics
, Thorny et al, reviewed data from 13 trials and found that Chlorpromazine was associated
with better functioning and reduced symptom severity compared with a placebo
Suggests typical antipsychotics are beneficial as they have been found to be effective in the
treatment of SZ
Problem = typical antipsychotics have side effects which range from mild to fatal and can
result in the onset of further life altering disorders
✓ - Support for effectiveness of atypical antipsychotics
Meltzer et al, concluded that Clozapine is more effective than typical antipsychotics and it is
30-50% more effective in treatment-resistant cases
Suggests atypical antipsychotics are beneficial for patients with SZ
X - Suggested the evidence to support the effectiveness of antipsychotics is exaggerated
Healy et al, some successful trials have been published multiple times exaggerating positive
effects
Most studies also only review short-term effects
Overestimates the effectiveness of antipsychotics
X - Dopamine theory (premise of using antipsychotics is based on) has flaws
Evidence that dopamine levels in other parts of the brain are too low rather than too high
meaning antipsychotics shouldn’t work
Even though atypical psychotics have been successful in eradicating most side effects, they
do still exist and therefore remain a weakness
