First developed in 1950s

Example - chlorpromazine

• Affects neurotransmission

• Blocks dopamine

• Acts as an antagonist of D2 receptors

First developed in 1990s

Example - Clozapine

• same mechanism as conventional

• Psychiatry could treat mental disorders in the same way that physical disorders are treated.

• 75% of those given a conventional antipsychotic were considered to be 'much improved' compared with only 25% of those given a placebo.

• None of the patients given the antipsychotic were considers to have gotten worse, in comparison to 48% of those given a placebo.

Ravanic et al (2009)

• Compared effectiveness of Clozapine, Chlorpromazine and Haloperidol in 325 individuals with schizophrenia, over 5 years.

• Found significant differences in psychometric scores measuring schizophrenic symptoms, favouring clozapine.

• Clozapine had fewer adverse effects (0.9 events per patient) than haloperidol (2.7) and Chlorpromazine (3.2)

• This suggests that atypical antipsychotics are more effective and preferable when treating schizophrenia.

  :( More research need to be done based on individual differences

• Those with chronic schizophrenia lack the necessary insight into their own condition. They don't believe they have a problem and therefore don't take their medication.

  Rettenbacher et al (2004)

• Found full compliance in only 54.2% of those with schizophrenia, non compliance in 37.5%.

• This suggests that in the real world antipsychotics may not be as effective as they are in closely controlled clinical studies.

Agranulocytosis - a deficiency of granulocytes in the blood, causing increased vulnerability to infection.

Seizures - occur after an episode of abnormal electrical activity in the brain. Convulsions can also occur when a person's body shakes rapidly and uncontrollably.

Parkinsonianism - tremors and instability.

:( therapist has to make decision for the patient as to whether or not the treatment is worth the side effects that the patient may suffer from.

:( no valid consent - not of a sound mind

Szasz (1960)

• physical treatments is no more sophisticated than believing in demonology.

• Concept of metal illness was a way of excluding non conformists from society

  
  

• Antipsychotics have revolutionised the care of schizophrenia

• Changed from an incurable condition which required institutionalised, to one that could be treated in the community, with the potential for independent living and recovery

:) introduction of medication allowed patients to live a more normal life with their loved ones in their home environment

:) beneficial due to the avoidance of the expense of hospitalisation

Tiihonen et al (2006)

• Found a 37-fold increase in suicide in patients who stopped taking their medication

NCISH (2015)

• 346 homicides committed in England with a history of schizophrenia between 2003 and 2013 - 6% of the total homicide rate)

• 29% of these individuals had been non-adherent with drug treatment in the month before the homicide

:( cannot determine cause and effect here

:) still strong enough to be considered as a risk factor