Antipsychotic medication
Treat forms of psychotic illness. They help the person with the disorder to function as well as possible in their life and, as well as increasing their feelings of subjective wellbeing.
Conventional antipsychotic drugs
Reduce the effects of dopamine and so reduce the symptoms of schizophrenia.
They are dopamine agonists- They bind to dopamine receptors but do not stimulate them, thus blocking their action. By reducing stimulation of the dopamine system, these drugs can eliminate the hallucinations and delusions.
This lead to the dopamine hypothesis.
(+) (Davis, 1980)– There was a significant difference in terms of relapse between the treatment and placebo groups that were viewed. Thus demonstrating their effectiveness.
(-) (Vaughn and Leff, 1976)– Drugs only made a difference for those living in hostility and criticism in their home environment. In such conditions the relapse rate for those on medication was 53% compared to 92% for those on placebos. However, for those living in more supportive home environments there was no significant difference, with 12% compared to 15%.
(-) (Ross and Read, 2004)– Placebo’s are not a fair comparison because under placebo conditions the patient is in withdrawal which means dopamine systems become flooded because of the sensitivity and increased receptors. This results in an overwhelming of the dopamine system, thus a proportion of the relapses in placebo can be explained by the withdrawal.
(-) Tardive Dyskinesia- Loss of control over the lips, tongue, face, hands and feet. 30% of people taking antipsychotics get it and it is irreversible in 75% of cases.
Atypical antipsychotic drugs
These temporarily occupy D2 receptors and then rapidly dissociate to allow normal dopamine transmission.
These are thought to have lower levels of side effects compared to conventional antipsychotics.
(-) (Leucht, 1999)– Of the new drugs tested, only 2 were ‘slightly’ more effective, one ‘as effective’ and one ‘slightly worse’, which means that the claim that atypical antipsychotics are particularly effective with the negative symptoms has marginal support.
(+) (Jeste et al., 1999)– found tardive dyskinesia rates in 30% of people after 9 months of treatment with conventional antipsychotics, compared to 5% in atypical. There are also fewer side effects, meaning they are more likely to continue their medication and see more benefits.
Electroconvulsive therapy (ECT)
The patient is given a short-acting barbiturate, so they are unconscious before the shock is administered. They are given a nerve-blocking agent to paralyse the muscles. An electric current is then passed for 1/2 second through the brain, producing a seizure lasting up to one minute, which effects the entire brain.
(-) (American Psychiatric Association, APA)– When ECT was compared with ‘Sham ECT’, ECT produced results that were no different from or worse than antipsychotic medication.
(-) (Sarita et al., 1998)– found no difference in symptom reduction between 36 schizophrenia patients given either ECT or Stimulated ECT.
(-) Risks- There are significant risks including memory dysfunction, brain damage, and even death, thus there was a decline of 59% between 1979 and 1999.
(Tharyan and Adams, 2005)– When ECT was compared with Sham ECT more people improved in the real condition. However, there was no indication that it was over a medium or long-term. When ECT was compared with antipsychotic medication groups the results favoured the medication. However, there was some indication that when both were combined it resulted in a greater improvement in mental state.