Biological Therapies: Drug Therapy (Antipsychotics)

Antipsychotic drugs

Medications used to reduce the intensity of schizophrenia symptoms.

Typical antipsychotics

First-generation drugs developed in the 1950s.

Chlorpromazine

A widely used typical antipsychotic.

Typical antipsychotics mechanism

Dopamine antagonists that block D2 receptors to reduce dopamine activity.

Effect on positive symptoms

Reduces hallucinations and delusions by lowering dopamine levels.

Sedative effect

Chlorpromazine has a calming effect, used for agitated patients.

Typical antipsychotic side effects

Include dizziness, stiffness, dry mouth, weight gain and drowsiness.

Tardive dyskinesia

Involuntary facial and mouth movements caused by long-term use of typical antipsychotics.

Atypical antipsychotics

Second-generation drugs developed to improve effectiveness and reduce side effects.

Clozapine

The most effective atypical antipsychotic, used when others fail.

Clozapine mechanism

Acts on dopamine, serotonin and glutamate receptors.

Clozapine benefits

Improves mood and reduces suicidal thoughts as well as psychotic symptoms.

Clozapine risk

Agranulocytosis, a potentially fatal reduction in white blood cells.

Risperidone

An atypical antipsychotic with fewer side effects than clozapine.

Risperidone mechanism

Strong dopamine blockade with lower doses needed.

Effectiveness of atypicals

More effective for negative symptoms and cognitive symptoms.

Strength: effective treatment

Antipsychotics reduce symptom severity and allow many patients to live outside hospital.

Strength: real-world functioning

Improves quality of life and ability to engage in therapies.

Strength: scientific evidence

Research consistently shows antipsychotics outperform placebo.

Limitation: side effects

Some severe and long-lasting; impact adherence.

Limitation: ethical issues

Patients may be given medication involuntarily.

Limitation: not a cure

Reduces symptoms but does not address underlying causes.

Limitation: relapse common

High relapse rates when medication stopped.

Drug vs psychological therapies

Drugs reduce symptoms quickly; therapies target cognition and social functioning.

Combination treatment

Often used with CBT or family therapy for best outcomes.