DRUG TREATMENTS Schizophrenia

Atypical Antipsychotic drugs Include drugs such as; Clozaril, Risperdal and Zyprexa These drugs also block dopamine as with the neuroleptic drugs but they concurrently alter serotonin levels within the body, therefore tackling negative symptoms too. Atypical drugs are largely as effective as neuroleptics and have the added advantage that the side effects are less bad.

Awad and Voruganti % patients benefited from these drugs compared to only 65%on the neuroleptics. What however could be the flaw with findings such as these?

Meltzer 1999 About a third of patients who do not respond to neuroleptic drugs show improvement when given atypical drugs instead.

Side effects 1-2% of patients on Clozapine suffer from agranulocytosis which can be fatal and lead to a massive reduction in white blood cells. There are other alternatives to this particular drug however that do not seem to produce this effect.

How Effective are Drug Therapies on the treatment of schizophrenia? Drugs have been proven to be more effective than other type of therapy. Patients on drug therapies show much faster signs of recovery than when just having psychological therapy. Drugs allow those who would otherwise be sectioned to live in society and have relatively normal lives. BUT…

Negatives… Neuroleptic drugs do not work on the negative symptoms Drugs do not work on all patients. The drugs used to treat schizophrenia are palliative which means they treat the symptoms but cannot ‘fix’ or ‘cure’ the underlying cause. This means patients will have to be on medication for long periods of time and can develop resistance to the drugs.

Are drug therapies appropriate? Schizophrenia has more of a biological backing than any other mental health condition. Drugs therefore are the logical treatment. Also, as we know Dopamine certainly plays a key part in the onset of the condition – drugs that block dopamine receptors are clearly therefore appropriate.

Or inappropriate? The side effects are serious, sometimes fatal Issues of consent The only way of reducing side effects in lower doses… Compliance of patients on mediation Drugs are treating the symptoms not the cause As the drugs do not ‘cure’ the condition patients will be medicated in most cases for life. This is not desirable as the longer you taken them for the worst the side effects get… Even the newer more effective drugs still do not work on around 15% of patients…

BIOLOGICAL TREATMENTS FOR ABNORMALITY ECT

The Historical picture The modern picture

ECT (Electro Convulsive Therapy) Anesthetised seizures Used to treat severe depression / negative symptoms of schizophrenia 60 second episodes, similar to an epileptic fit. ECT has therapeutic qualities Patients usually have 6-12 episodes. In the old days they rarely used relaxants which led to brain burns and broken burns… things are better now…!! The treatment is used predominantly for those who cannot take anti depressants or are in the ‘danger zone’ for self harm.

Effectiveness Eranti 2007 showed ECT is effective in the short term but long term symptoms are likely to come back.

Ethics The main side effects of ECT are memory loss (usually minor and short term) but can get worse over a longer course of treatment – Lisonby Consent – There is a question as to whether someone with depression can consent. Consent is not needed if someone has been sectioned, over 2000 people are given non consensual ECT a year. Of those who did consent Rose 2005 found that approximately 50% of patients did not fully understand what ECT was all about.

Extra Reading… Have a look at … …and evaluate at least two of the articles in regard to the use of ECT. Consider; -How does ECT work in the treatment of Schizophrenia? -Is the treatment appropriate? -Is the treatment effective ….for Schizophrenia? (10 marks)