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 describe 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.

DISCOVERY In the mid 1950s it was discovered that large daily doses of Amphetamines could produce a psychosis identical to schizophrenia Amphetamine increases D2 transmission 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

ANTIPSYCHOTIC DRUGS 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

Chemotherapy ~ what do you think this term means? 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 different neurotransmitters

Phenothiazines: decreases dopamine activity. Reduces positive symptoms (hallucinations, delusions, etc.). Fails to reduce negative symptoms (flat affect, low motivation, etc.). Unpleasant side effects: dizziness, nausea, sexual impotence, tardive dyskinesia (involuntary facial movements), etc. May cause permanent biochemical changes reducing possible eventual full recovery. 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.

“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).

TASK Using books, internet, other resources, complete pg 29 in your packs A good website is Mind ~ http://www.mind.org.uk/information-support/drugs-and-treatments/antipsychotics/the-different-types-of-antipsychotics/#.VOoYvFJFDIU Thought shower some evaluation points for drugs as a treatment for schizophrenia What research can you use to support your evaluation points?

Evaluation of biological treatments Side Effects Not effective for everyone Little Effect on Type 2 Symptoms Cost / Time Effective Evidence to support effectiveness Can be used in combination with other therapies

Drug therapy as a form of social control I and D… Drug therapy as a form of social control

Social control Social control is a formal way of making individuals conform to society’s rules. Drug therapy can be considered a form of social control as they are used to help make patients behave more ‘normally’, according to the society’s social norms.

Practical Issues Compliance rates are low which leads to increased relapse rates Also anti-psychotics only treat symptoms and not the causes which may mean drug therapy is not an effective means of controlling abnormal behaviour However, relatively cost-effective to society, allowing behaviour to be controlled away from the institution setting

Ethics P - Anti-psychotic drugs can have many distressing and possibly painful side-effects, which the patient is not protected from - The patient can become addicted to and dependent on the drug prescribed, which limits the control they have over the treatment process. C - Both of these points mean informed consent must be gained.

Outline the findings of Meltzer (2004) RESEARCH! Outline the findings of Meltzer (2004) See Brain pages 253-254 See Blog for skinny red material You could also have a look at Mind, NHS websites to see what they are saying about drug treatments

Complete the worksheet on the Kane et al Research A – To Carry out a one year double blind study to see the effectiveness of Fluphenazine as a treatment for Schizophrenia P – Longditudinal study of 28 Patients referred to a New York clinic with a diagnosis of Schizophrenia. Independent Measures design, random allocation of drug or placebo. Patients dropped out if they had toxic side effects or relapsed. R – 7/17 patients receiving the placebo had relapsed by 19 weeks. Among drug treatment there were no relapses. Toxic side effects of the drugs did cause 2 receiving treatment to drop out by 32 weeks. C- Patients with one episode of schizophrenia can be successfully treated using Fluphenazine once they are in remission.

Group Activity Imagine that you work in the Pharmaceutical industry. Prepare a poster to present your drug to the rest of the group. Include any possible side effects of your drug.