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Therapies for SCZ
- Biological therapies
- Genetics therapy
- Ethical issues with changing genetics
- Productions of anti-psychotics drugs to
reduce dopamine levels such as
chlorpromazine, clozapine. These block
dopamine receptors, to reduce the amount of
dopamine being passed to the next cell
- Conventional Anti-psychotics
- Chlorpromazine are used to combat
positive symptoms of scz, which are
products of an overactive dopamine
system. these are dopamine
antagonists as they block dopamine
receptors (D2 especially) which
reduces the amount of dopamine
passed onto the next cell
- The effectiveness of the drugs
- Davis et al 1980 analysed 29 studies and found the relapse rates
occurred in 55% of patients who were on the placebo, and 19% of
those on the drugs. Thus showing how the conventional antipsychotics
actually reduce the effects of scz.
- Davis et al 1980 analysed 29 studies and found the relapse rates
occurred in 55% of patients who were on the placebo, and 19% of
those on the drugs. Thus showing how the conventional antipsychotics
actually reduce the effects of scz.
- Issues
- It only works on the positive symptoms and neglects all negative
symptoms. which are those behaviours which lack function ability. It
being an issue as these are severe affect on human behaviour.
- Drugs can cause tardive dyskinesia (uncontrollable movements of lips, tongue, face, hand
and feet). 30% of people on antipsychotic meds develop this and it isn't reversible,
creating an issue for the whole of a persons life. this will affect a persons quality of life
which creates the mind set of not taking the drugs in the first place.
- Evidence against Davis' study: Ross and Read claimed that Davis' study was unfair as the relapse
rates in the placebo condition could be due to the withdrawal of the real medication. All of the
patients were originally on medication and the body may have become biologically adapted to the
drug such as increased amount of D2 receptors which occur when the patient is deprived of the
drug. Therefore it is argued that the increase in D2 receptors is the real cause of the relapse and not
the lack of the drug.
- Evidence against Davis' study: Ross and Read claimed that Davis' study was unfair as the relapse
rates in the placebo condition could be due to the withdrawal of the real medication. All of the
patients were originally on medication and the body may have become biologically adapted to the
drug such as increased amount of D2 receptors which occur when the patient is deprived of the
drug. Therefore it is argued that the increase in D2 receptors is the real cause of the relapse and not
the lack of the drug.
- It only works on the positive symptoms and neglects all negative
symptoms. which are those behaviours which lack function ability. It
being an issue as these are severe affect on human behaviour.
- Conventional antipsychotics have many die effects wand some flaws and since their creation, Atypical antipsychotics (clozapine)
were created. These have less side effects as the act on the dopamine system receptors in the brain too. they also work on the
positive and some negative symptoms (by acting on serotonin) . this makes it a much better alternative than conventional as they
appear and disappear allowing a frequent flow of dopamine. however the is one severe side effect and it also lowers the immune
system
- Leucht conducted a meta analysis comparing the effectiveness of
conventional and atypical antipsychotics. The researchers found that 2
of the newer atypical were slightly more effective while the 2 other
atypical were deemed to be no different in terms of effectiveness.
Therefore some atypical may be more effective however there is only
a small degree of improvement in effectiveness.
- Atypical can treat negative and positive symptoms: Leucht also looked at the typical effectiveness at
treating the negative symptoms. Here they found 2 were slightly more effective than conventional
antipsychotics, 1 was just as effective and 1 was slightly less effective.
- Atypical can treat negative and positive symptoms: Leucht also looked at the typical effectiveness at
treating the negative symptoms. Here they found 2 were slightly more effective than conventional
antipsychotics, 1 was just as effective and 1 was slightly less effective.
- Leucht conducted a meta analysis comparing the effectiveness of
conventional and atypical antipsychotics. The researchers found that 2
of the newer atypical were slightly more effective while the 2 other
atypical were deemed to be no different in terms of effectiveness.
Therefore some atypical may be more effective however there is only
a small degree of improvement in effectiveness.
- The effectiveness of the drugs
- Chlorpromazine are used to combat
positive symptoms of scz, which are
products of an overactive dopamine
system. these are dopamine
antagonists as they block dopamine
receptors (D2 especially) which
reduces the amount of dopamine
passed onto the next cell
- Conventional Anti-psychotics
- Ethical issues with changing genetics
- ECT
- Used under false assumptions that inducing epileptic fits would
remove the disorder because epilepsy= scz couldn't exist together
more effective than placebo- less effective than drugs
- Electrodes placed on scalp with one on non dominant side and other on
forehead. Nerve blocking agent to paralyse muscles to prevent contraction.
an Electric current is passed and seizures last up to a minute. This is only used
as a LAST RESORT. It done 2-3 times a week with 12 treatments.
- Electrodes placed on scalp with one on non dominant side and other on
forehead. Nerve blocking agent to paralyse muscles to prevent contraction.
an Electric current is passed and seizures last up to a minute. This is only used
as a LAST RESORT. It done 2-3 times a week with 12 treatments.
- Good short term but drugs are more effective
- Useful ion those who
aren't responding to
antipsychotic drugs
+ show rapid results
which combined.
- ECT could be more effective with treating certain types of scz but the damages are not fully known
- Ethical issues raised due to damage= memory loss
- Reductionist not aware of complications
- Used under false assumptions that inducing epileptic fits would
remove the disorder because epilepsy= scz couldn't exist together
more effective than placebo- less effective than drugs
- Genetics therapy
- Psychological Therapies
- CBT (Cognitive Behavioural Therapy)
- Works by changing the schizophrenics faulty thinking, which
influences their maladaptive behaviour. It identifies and corrects
delusions.
- Example: Val who said she did have her psychotherapist who would
help change her faulty thinking. They also worked on coping startegies,
which can be helpful but some don't work. Val did say that the therapy
was helpful and helped her out of therapy
- Example: Val who said she did have her psychotherapist who would
help change her faulty thinking. They also worked on coping startegies,
which can be helpful but some don't work. Val did say that the therapy
was helpful and helped her out of therapy
- Supporting research shows how useful CBT was.
Gould et al 2201 found all 7 studies in their
meta-analysis reported a statistically significant
decrease in the positive symptoms of scz after
treatment and with medication (antipsychotics)
- However, CBT doesn't work for everyone as shown in a study of 142 scz PPs,
finding that many patients were not deemed suitable for CBT as some may
not fully engage with therapy as it's very long and you have to always go
back. Nonetheless it's more human than drugs by leaving less side effects,
but it could work as the sczs may have someone to talking to instead of the
therapy itself
- However, CBT doesn't work for everyone as shown in a study of 142 scz PPs,
finding that many patients were not deemed suitable for CBT as some may
not fully engage with therapy as it's very long and you have to always go
back. Nonetheless it's more human than drugs by leaving less side effects,
but it could work as the sczs may have someone to talking to instead of the
therapy itself
- Works by changing the schizophrenics faulty thinking, which
influences their maladaptive behaviour. It identifies and corrects
delusions.
- Family intervention
- Works by reducing the Levels of EE + stress by:
- Forming alliances with relatives who care
- Reducing emotional climates in families
- Reducing anger and guilt by family members
- Forming alliances with relatives who care
- Supporting evidence= 32 studies in a meta analysis= significant
evidence of effectiveness of family intervention (NICE, 2009)=
effectiveness
- Appropriateness- cultural limitation= NICE 2009- Most evidence
from outside the UK and data may not be applicable in the UK
- Works by reducing the Levels of EE + stress by:
- CBT (Cognitive Behavioural Therapy)
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