Drug Therapy for Schizophrenia (AQA A Level Psychology): Revision Note

Typical antipsychotics

• Antipsychotic drugs are used to treat a range of mental disorders, including schizophrenia (psychotic refers to any condition in which a person loses touch with reality)

• Typical antipsychotics are also known as first-generation antipsychotics, as they have been in use since the 1950s

• Typical antipsychotics are dopamine antagonists, i.e., they inhibit dopamine activity by blocking dopamine receptors in the synapse

• Examples of typical antipsychotics include

  • chlorpromazine,

  • trifluoperazine

  • acetophenazine

  • haloperidol 

• Typical antipsychotics are effective at treating the positive symptoms of schizophrenia, e.g. delusions

• Haloperidol and chlorpromazine come with side effects, some of which are quite severe, e.g., drowsiness, agitation, dry mouth, blurred vision, lack of emotional response, dizziness, muscle stiffness or spasms

• Over-use of typical antipsychotics may lead to tardive dyskinesia or neuroleptic malignant syndrome (a result of dopamine being blocked in the thalamus)

Atypical antipsychotics

• Atypical antipsychotics are second-generation antipsychotics developed in the 1980s as a solution to the potentially damaging side effects of typical antipsychotics

• Atypical antipsychotics are dopamine antagonists, they inhibit dopamine activity by blocking dopamine receptors in the synapse, but they may act as serotonin agonists as they inhibit serotonin reuptake in the synapse

• Both the positive and negative symptoms of schizophrenia are treated with atypical antipsychotics

• Examples of atypical antipsychotics include

  • risperidone

  • olanzapine

  • brexpiprazole

  • clozapine

• Clozapine is prescribed when other antipsychotic drugs have not worked; it also helps to reduce tardive dyskinesia

• Clozapine may act on serotonin receptors, which can help to balance mood 

• Risperidone is thought  to act in the same way as antidepressants 

Research which investigates drug therapies

• Marder & Meibach (1994) - Schizophrenic patients who took risperidone compared to haloperidol or a placebo showed significant improvement in both positive and negative symptoms 

• Geddes et al. (2000) conducted a review of research and found that there is no real difference in effectiveness between first- and second-generation antipsychotics

  • Typical antipsychotics should be prescribed in the early stages of an episode of schizophrenia unless the patient has previously had side-effects including disjointed movement or muscles spasms

Evaluation of drug therapies in A Level Psychology

Strengths

• There is a body of compelling research evidence which suggests that antipsychotics are an effective treatment for schizophrenia

• Antipsychotics are most effective at treating patients with the most severe symptoms who may not be treatable using non-drug therapies (Furakawa et al. 2015)

Limitations

• Patients with milder, less extreme forms of schizophrenia benefit less from taking antipsychotics and may additionally experience adverse side effects

• It is not clear how effective antipsychotics are in preventing relapses in patients who are in remission

Issues & Debates

• Drug therapies support a biological determinist view, as they assume schizophrenia symptoms are caused by neurochemical imbalances

  • This can undermine the patient’s sense of control over their condition and implies that behaviour is driven by biology, not personal choice or cognitive factors

• Drug therapies take a biologically reductionist approach, treating schizophrenia as purely a chemical imbalance

  • They overlook important psychological and social factors (e.g., cognitive dysfunction, family environment)

  • This limits the explanation’s holistic value and may reduce long-term treatment success if non-biological causes are left unaddressed