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 explain 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.

Chemotherapy 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 various neurotransmitters

Lets remind ourselves of the Dopamine Hypothesis: Group poster activity Lets remind ourselves of the Dopamine Hypothesis: Use this poster to propose how you could design a Drug Therapy

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

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.

Group Activity Make a drug marketing poster to describe the usefulness of your chosen drug. You must include health warning / side effects information on your poster.

Using p111 of text book Pickar (1992) Emsley (2008)

“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).

Evaluation of biological treatments