A* AQA A Level Psychology 16 marks Treatment of schizophrenia
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Treatment for schizophrenia (Antipsychotics) – 16 marker
The most common treatment for schizophrenia involves the use of antipsychotic drugs.
Antipsychotics are used to reduce the intensity of symptoms, in particular the positive
symptoms of psychotic disorders like schizophrenia. “Antipsychotic” refers to psychosis. A
person with psychosis experiences a loss of contact with reality and is the defining
characteristic of schizophrenia and related disorders. Antipsychotics may be required in the
short or long term. Some people can take a short course of antipsychotics then stop their
use without the return of symptoms, whereas others may require antipsychotics for life.
Antipsychotics can be divided into typical and atypical antipsychotics.
Typical antipsychotics, the traditional first-generation drugs, have been used since the
1950s. An example of a typical antipsychotics is chlorpromazine which can be taken as
tablets, syrup or by injection. If taken orally, it is administered daily up to a maximum of
1000 mg, although initially doses are much smaller and for most people is gradually
increased to a maximum of 400 to 800 mg. Liu and de Haan found that typical prescribed
doses have declined over the last 50 years. There is a strong association between the use of
typical antipsychotics like chlorpromazine and the dopamine hypothesis. Typical
antipsychotics like chlorpromazine work by acting as antagonists in the dopamine system.
Antagonists are chemicals which reduce the action of neurotransmitter. Chlorpromazine
works as a dopamine antagonist which means it work against the effect of dopamine and
blocks the receptor sites of dopamine at the post synaptic neurone. This reduces the action
of dopamine so when an individual starts taking chlorpromazine dopamine levels build up,
but then its production is reduced. decrease the amount of dopamine or reduce number of
receptors so best thing to do is block the receptors. According to the dopamine hypothesis
of schizophrenia, this dopamine-antagonist effect normalises neurotransmission is key areas
of the brain, reducing positive symptoms such as hallucinations. Chlorpromazine has been
found to be an effective sedative. This is believe to be related to its effect on histamine
receptors. Chlorpromazine is often used to calm individuals not only with schizophrenia but
also with other conditions. For example, this has often been done with patients who are first
admitted to hospitals and are very anxious. It is important consider whether chlorpromazine
is actually be treating and targeting symptoms of schizophrenia or whether is is merely a
sedative. Lastly, one further side effect of typical antipsychotics is the risk of developing
tardive dyskinesia. This is a serious side effect that can happen if you take typical
antipsychotic drugs for a long period of time.
Atypical antipsychotics, the second generation drugs, have been used since the 1970s,
therefore they were developed after typical antipsychotics. The aim in developing newer
antipsychotics was to maintain or improve upon the effectiveness of drugs in suppressing
the symptoms of psychosis and also minimise the side effects of the drugs used. There are a
range of atypical antipsychotics and they do not all work in the same way as they target
different neuotransmitters such as dopamine, serotonin and glutamate. Clozapine was
developed in the 1960s and first trailed in the 1970s. It was withdrawn for a while following
deaths of some patients with a blood condition called agranulocytosis. However, in 1980s it
was discovered to be more effective than typical antipsychotics. Clozapine was remarketed
as a treatment for schizophrenia. Clozapine is still used today, and people taking it have
regular blood tests to ensure they are not developing agranulocytosis. Because of its
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