Treatments of Schizophrenia

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Evaluate the key drugs used to treat schizophrenia.

Schizophrenia is one of the most common severe mental disorders effecting between 0.5% and 1% of the population (Sartorius at al, 1986) and is greatly discussed as not being a single condition but rather a combination of related issues and has several criteria’s in existence to help in the diagnosis. DSM-IV-TR (APA 2000) states that two or more symptoms including delusions, hallucinations, disorganised speech, catatonic behaviour or negative symptoms for a period of one month. An alternative diagnosis is which symptoms cluster together and whether they form disorganised, positive and negative symptoms (Liddle et al. 1994). Current treatments for schizophrenia are divided into drug treatments, psychological and social management and electroconvulsive therapy.

Drug treatments have developed around the biological explanations of the causes of Schizophrenia. There are ample studies around but problems with some of the research in this area such as supporting research; Johnstone (2000) for the dopamine hypothesis. This research was carried out on people that already suffered from schizophrenia and therefore these individuals would have already be taking some form of drug treatment, which may cause side effects that resembled symptoms and stress of the disorder would likely impact on the results of the research. Drug treatments has been researched thoroughly and it is practical to say that they are effective in the treatment of positive and negative symptoms of schizophrenia.

The key drug treatments in schizophrenia are antipsychotic medication. They have been around since the 1950’s and comprise of two main types, the older typical antipsychotics and the newer atypical antipsychotics. These are the most effective drug treatments available and majority of people with schizophrenia show significant improvement of positive and negative symptoms when treated with these drugs such as hallucinations and psychotic symptoms but have limited impact on thinking and behaviour. Drugs treatments are used to reduce the schizophrenic symptoms so they can function more appropriately and do not act as a chemical straitjacket in majority of cases. In addition, they will not return the person to their former self only allow them to rationalise their world and therefore help the person manage the disorder. CATIE research into whether typical or atypical effectiveness found that older medication worked as well as the newer and it is down to the individual to how they respond.

The first antipsychotic drugs or typical antipsychotic where referred to as neuroleptics such as chlorpromazine and haloperidol. These drugs work by blocking dopamine receptors and can be effective in the short term. In the long term, however they can make the receptors more sensitive and therefore can result in the individual requiring more long-term treatment. Neuroleptics have possible unwanted side effects as well as benefits for the individual including drowsiness, restlessness and more severe side effects that include Tardive dyskinsia (TD) and this can be irreversible. TD occurs in over 20% of people that take typical antipsychotics for longer than three months (APA 1992). The older drugs can also produce side effects that appear to be symptoms and depression which then the individual has to take antidepressants and antipsychotics. Constant monitoring is required and frequent meetings making these drugs not suitable for some patients, as they may not be able to adhere to the scheduling. Chlorpromazine has been confirmed in to be a “valuable drug treatment that properties are evident after a year and quantified as a both value drug and one which has adverse effects”, Thornley et al 1999.

The newer key drug treatments introduced in the 1990’s called atypical antipsychotic drugs include clozapine and even newer risperidone and olanzapine. These drugs affect the NMDA receptors and reduce...
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