Outline and evaluate two or more therapies used in the treatment of Schizophrenia (24 marks)
There is no established permanent cure for Schizophrenia, but there are a variety of therapies which help prevent schizophrenic episodes and also help sufferers deal with their mental illness. One of the main types of therapy used is drug therapy. Drug therapy involves issuing a patient psychotherapeutic drug(s) which are used to alter the chemical functioning of the brain by affecting the action of neurotransmitters. Neurotransmitters transmit signals between nerve cells called synapses. Neurotransmitters lead to changes in moods, feelings, perception and behaviour. The main category of drugs used for treating Schizophrenia is anti-psychotic drugs or neuroleptics. These lessen psychotic symptoms such as delusions and hallucinations, examples of these drugs could be chlorpromazine or clozapine. Typical antipsychotic drugs (neuroleptics) work by reducing dopamine within schizophrenia sufferers. Common forms of neuroleptics include drugs such as Thorazine, Prolixin and Haldol. These drugs actually block the activity of the dopamine neurotransmitter, the drugs take effect within 48 hours but it can be several weeks before a noticeable difference is seen with symptom reduction. Barondes’s (1993) research looked into balancing the dosage of the drug, lowering the drug dosage reduced the side effects but also reduced the effectiveness of the drug meaning it wouldn’t necessarily be a successful or quick recovery compared to high dosages of the neuroleptics. Although this showed clear evidence for the effectiveness of neuroleptics in combating schizophrenia, emphasized when changing the dosage changes the effectiveness of the neuroleptics. Comer’s (2001) research study looked into the effectiveness of the drugs, and found that for the majority of schizophrenia sufferers the drugs were effective and are the most successful treatment as they are more effective as a single treatment opposed to other therapies available.
Researches conducted about neuroleptics shows neuroleptics are effective in reducing the symptoms of schizophrenia especially positive symptoms such as hallucinations and delusions. Although relapse rates appear to be high and fast from coming off the drugs, meaning that essentially the patients will need to permanently take these drugs. Neuroleptics are well known for their large set of side effects that are damaging to patients health and wellbeing, reports of sedation, grogginess, blurred vision and impaired concentration. Approximately 2% of all patients who are using neuroleptics develop neuroleptic malignant syndrome which involves the patient gaining muscle rigidity, altered consciousness and fevers which can be fatal. Another serious side effect that is a negative to neuroleptics is that around 20% or more patients who have been regularly taking the drugs for over 1 year end up developing tardive dyskinesia which results in strange sucking and chewing, jerky limb movements and writhing of the mouth or face and even if the patient comes off the drugs these effects can be lifelong.
Although Birchwood and Jackson’s (2001) provided contradictory evidence as their study concluded that there was no evidence that the use of neuroleptics were effective within treating the negative symptoms.
Newer drug therapy for Schizophrenia is using atypical antipsychotics such as Clozaril and Zyprexa. These drugs work in the same way as typical antipsychotics by blocking/lessening the effects of the dopamine neurotransmitter but they also alter serotonin activity. Meltzer (1999) found in his study that roughly 33% of patients who’ve had no success when using neuroleptics responded much better with the atypical drug “clozapine”. Awad and Vruganti (1999) also backed the atypical drugs success rates when their study showed that 85% of patients suffering with schizophrenia benefitted from being on atypical drugs compared to the...
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