Transcript Biological Treatments for Abnormality

DRUG TREATMENTS
Schizophrenia
Atypical Antipsychotic drugs
• Include drugs such as;
• Clozaril, Risperdal and Zyprexa
• These drugs also block dopamine as with the neuroleptic
drugs but they concurrently alter serotonin levels within
the body, therefore tackling negative symptoms too.
• Atypical drugs are largely as effective as neuroleptics and
have the added advantage that the side effects are less
bad.
Awad and Voruganti 1999
• 85% patients benefited from these drugs compared to
only 65%on the neuroleptics.
• What however could be the flaw with findings such as
these?
Meltzer 1999
• About a third of patients who do not respond to
neuroleptic drugs show improvement when given atypical
drugs instead.
Side effects
• 1-2% of patients on Clozapine suffer from agranulocytosis
which can be fatal and lead to a massive reduction in
white blood cells.
• There are other alternatives to this particular drug
however that do not seem to produce this effect.
How Effective are Drug Therapies on the
treatment of schizophrenia?
• Drugs have been proven to be more effective than other
type of therapy.
• Patients on drug therapies show much faster signs of
recovery than when just having psychological therapy.
• Drugs allow those who would otherwise be sectioned to
live in society and have relatively normal lives.
• BUT…
Negatives…
• Neuroleptic drugs do not work on the negative symptoms
• Drugs do not work on all patients.
• The drugs used to treat schizophrenia are palliative which
means they treat the symptoms but cannot ‘fix’ or ‘cure’
the underlying cause. This means patients will have to be
on medication for long periods of time and can develop
resistance to the drugs.
Are drug therapies appropriate?
• Schizophrenia has more of a biological backing than any
other mental health condition. Drugs therefore are the
logical treatment.
• Also, as we know Dopamine certainly plays a key part in
the onset of the condition – drugs that block dopamine
receptors are clearly therefore appropriate.
Or inappropriate?
• The side effects are serious, sometimes fatal
• Issues of consent
• The only way of reducing side effects in lower doses…
• Compliance of patients on mediation
• Drugs are treating the symptoms not the cause
• As the drugs do not ‘cure’ the condition patients will be
medicated in most cases for life. This is not desirable as
the longer you taken them for the worst the side effects
get…
• Even the newer more effective drugs still do not work on
around 15% of patients…
BIOLOGICAL
TREATMENTS FOR
ABNORMALITY
ECT
ECT
• The Historical picture
• http://www.youtube.com/watch?v=QyN8OQzNWh4
• The modern picture
• http://www.youtube.com/watch?v=9L2-B-aluCE
ECT (Electro Convulsive Therapy)
• Anesthetised seizures
• Used to treat severe depression / negative symptoms of
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schizophrenia
60 second episodes, similar to an epileptic fit.
ECT has therapeutic qualities
Patients usually have 6-12 episodes.
In the old days they rarely used relaxants which led to
brain burns and broken burns… things are better now…!!
The treatment is used predominantly for those who
cannot take anti depressants or are in the ‘danger zone’
for self harm.
Effectiveness
• Eranti 2007 showed ECT is effective in the short term but
long term symptoms are likely to come back.
Ethics
• The main side effects of ECT are memory loss (usually
minor and short term) but can get worse over a longer
course of treatment – Lisonby 2000.
• Consent – There is a question as to whether someone
with depression can consent.
• Consent is not needed if someone has been sectioned,
over 2000 people are given non consensual ECT a year.
• Of those who did consent Rose 2005 found that
approximately 50% of patients did not fully understand
what ECT was all about.
Extra Reading…
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Have a look at …
www.ect.org/
https://www.rcpsych.ac.uk/expertadvice/treatmentswellbeing/ect.aspx
http://www.bbc.co.uk/news/health-23414888
http://www.schizophrenia.com/family/ect1.html
…and evaluate at least two of the articles in regard to the use of ECT.
Consider;
-How does ECT work in the treatment of Schizophrenia?
-Is the treatment appropriate?
-Is the treatment effective
….for Schizophrenia?
(10 marks)