The most frequent treatment for schizophrenia is use of anti-psychotic drugs. Conventional anti-psychotics such as Chlorpromazines were introduced in the 1950s. These are dopamine antagonists and work by blocking dopamine production through the D2 receptors in synapses that absorb dopamine therefore reducing positive symptoms such as hallucinations which are though to be caused by over-stimulation of the brain by dopamine.
Anti-psychotics can be divided into first generational (typical) and second generation (atypical) varieties. Atypical anti-psychotics work by reducing serotonin activity in the brain. They then act on dopamine receptors leading the patient to show fewer side effects.
Davis et al conducted a meta-analysis and found that over 70% of sufferers treated with anti-psychotics improved their conditions after 6 weeks. This suggests anti-psychotics were beneficial. However, 25% of sufferers also improved on placebo alone. Also 30% of those taking anti-psychotics did not improve. This suggests that effectiveness of drug therapies can vary between individuals therefore such differences must be taken into account when considering the appropriateness of treatment. The meta-analysis used over 100 studies therefore has high external validity and generalisations will be able to be made more accurately. Issues include demand characteristics may have affected whether treatment was successfully as some patients may have been more motivated and convinced the therapy would work. Therefore regardless of whether anti-psychotics or placebo was taken they would have had reduced symptoms.
Double-blind trials contradict Davis' findings suggesting the overall effectiveness of anti-psychotics is argued to be around 60%. Such trails are used to objectively test and to reduce demand characteristics with research helping to increase reliability. However, such research highlights issues regarding determining the effectiveness of drugs, as results vary. Double-blind trials may only be reliable as a short term measure for the effectiveness of drug therapies.
Drug therapies in the use of schizophrenia have had the major advantage of allowing suffers to lead normal lives where previously they may have been institutionalised for unmanageable symptoms. However, limitations occur for example not all patients responded to anti-psychotics, with around 40% being unresponsive. Both conventional and atypical anti-psychotics can produce negative side effects with conventional drugs being linked to Tardive Dyskinesia, a loss of muscle control, being irreversible in 75% of cases (Hill et al). Side effects raises problems of compliance and patients may stop taking them therefore causing schizophrenic symptoms to return or increase.
ECT has previously been used in treatment although today is highly controversial. ECT uses electric currents to induce a seizure in the brain. This has been seen to reduce schizophrenic symptoms in some but it is not understood as to how this works. The appropriateness of ECT has been questioned as in studies comparing ECT and simulated ECT found little difference in effectiveness. Also due to the uncertainly of effectiveness and ethical issues surrounding treatment, today it is not used in the treatment of schizophrenia as there is not sufficient research support for its effectiveness according to for example NICE (National Institute for Health Care and Excellence).
Biological therapies are deterministic as patients are reinforced to believe that they have less control over their disorder and that their behaviours are dictated by their biology. Also biological treatment can only treat symptoms of schizophrenia therefore once the patient stops taking medication symptoms will likely return. Often anti-psychotics are combined with other therapies e.g. CBT as from research one has not been found to offer a complete cure. Such treatments are also reductions in assuming schizophrenia is caused solely by biological causes. But, other research suggests psychological factors and environmental factors also play a role in onset and maintenance.
It has been argued medical professionals prescribe pills in the best interest in the companies producing the medication. This creates ethical concerns as they are not working in the interest of the patient. Therefore such issues highlight many factors that the patients must consider before engaging in biological treatments. However, when they work are proven to be very beneficial.
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