Treatment of Schizophrenia

Drug Therapies

Pre-Drug Therapy Prior to the discovery of psychological drugs, hospitals had few options with which to treat patients Most early treatment techniques are today considered archaic and sometimes cruel

Post-Drug Therapy With the discovery of effective drug treatments, patients were able to leave the institutions (deinstitutionalization).

Deinstitutionalization The release of patients from mental hospitals to the community at large The development of drug therapies led to an 80% decline in the number of hospitalized mental patients from 1950 to Many of the former patients became part of the homeless population.

Biomedical Therapies Widespread use of antipsychotic medications began in the mid-1950’s Can be related to number of patients in mental hospitals

Drug Therapies: Antipsychotic Drugs

Antipsychotic Drugs A category of medications used primarily to treat schizophrenia Reduces the levels of hallucinations and delusions and distorted thinking Drugs work primarily by blocking the activity of dopamine 2 Types: Typical and Atypical

Typical Antipsychotic Medications Typical antipsychotics ( Thorazine ) –Effective against positive symptoms of schizophrenia –Have uncomfortable side effects –Globally reduce brain dopamine levels Side effects include: dry mouth, blurred vision, constipation, and tardive dyskinesia Tardive dyskinesia – a permanent condition of muscle tremors Thorazine One of the first antipsychotic drugs

Schizophrenia Drug Therapy Insert “Schizophrenia” Video #34 from Worth’s Digital Media Archive for Psychology. (5:15) How does Augustine’s behavior change after 4 weeks on medication? Click HERE to view in a separate window (5 min).HERE Shorter version: Effectiveness of these drugs with a schizophrenic (2 min)Effectiveness of these drugs with a schizophrenic (2 min)

Drawbacks of Antipsychotic Medications The early antipsychotics didn’t actually cure schizophrenia; psychotic symptoms often returned if a person stopped taking the medication They were not effective in eliminating the negative symptoms of schizophrenia They often produced unwanted side effects They globally altered brain levels of dopamine, sometimes producing motor-related side effects; long- term use can cause tardive dyskinesia Patients go through a “revolving door” pattern of hospitalization, discharge, and rehospitalization View some of the Drawbacks of Antipsychotic Drugs (1 min)Drawbacks of Antipsychotic Drugs (1 min)

Atypical Antipsychotic Medications Newer drugs that may also be effective against negative symptoms of schizophrenia Affect levels of serotonin as well as dopamine Much less likely to cause movement-related side effects because they block dopamine brain receptors far more selectively Produce (sometimes dramatic) improvement in a significant proportion of patients who have not responded to traditional antipsychotic drugs