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

1. In the mid 1950s it was discovered that large daily doses of Amphetamines could produce a psychosis identical to schizophrenia

• Amphetamine increases D2 transmission

2. 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

• 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

ANTIPSYCHOTIC DRUGS

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

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.

1. Phenothiazines: decreases dopamine activity.

a. Reduces positive symptoms (hallucinations, delusions, etc.).

b. Fails to reduce negative symptoms (flat affect, low motivation, etc.).

c. Unpleasant side effects: dizziness, nausea, sexual impotence, tardive dyskinesia (involuntary facial movements), etc.

d. May cause permanent biochemical changes reducing possible eventual full recovery.

“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 28 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?

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

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

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.

Kane et al Worksheet – Fluphenazine vs Placebo in patients with Schizophrenia For each of the experimental groups complete the diagram to demonstrate of the effects of the drugs in the Schizophrenics Brains.

Fluphenazine Hydrochloride / Deaconate

1. Label Dopamine 2. Label D2 Receptor 3. Draw where Fluphenazine binds 4. Does the rate of Neural firing increase or

decrease in the presence of Fluphenazine?

Findings:

Placebo / No Drug Treatment

1. Label Dopamine 2. Label D2 Receptor 3. Would you expect to find more or less D2

receptors in the brains of schizophrenics? 4. Does the rate of Neural firing increase or

decrease in Schizophrenic patients?

Findings:

Evaluate the research:

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.