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Explain two different approaches for treating schizophrenia from the biological and cognitive perspectives.

A biological approach to treating schizophrenia is the use of antipsychotic drugs such as clozapine to prevent the hyperactive signal transduction of dopamine in the brain. A cognitive approach to treating schizophrenia is the use of cognitive behavioral therapy, or CBT, to change negative thoughts or actions.

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Biological treatments for schizophrenia are based on the "dopamine hypothesis," which posits that the positive symptoms of schizophrenia, such as hallucinations and delusions, are largely caused by hyperactive signal transduction of dopamine. The type of antipsychotic drugs now used in the treatment of schizophrenia (second-generation or "atypical" antipsychotics) work as...

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Biological treatments for schizophrenia are based on the "dopamine hypothesis," which posits that the positive symptoms of schizophrenia, such as hallucinations and delusions, are largely caused by hyperactive signal transduction of dopamine. The type of antipsychotic drugs now used in the treatment of schizophrenia (second-generation or "atypical" antipsychotics) work as receptor antagonists, binding to the receptor and preventing it from responding to dopamine.

The results of a meta-analysis of antipsychotics in the treatment of schizophrenia led by Professor Stefan Leucht of the Technical University of Munich were published in 2013 (abstract attached below). This study concluded that the most effective biological treatment currently available is Clozapine, an antipsychotic often sold under the brand name "Clozaril." Like other antipsychotics, it works by blocking dopamine, but for reasons that are not clear, it has been effective in treating schizophrenia when patients fail to respond to other antipsychotics.

As noted above, biological treatments are used primarily to manage positive symptoms of schizophrenia. However, schizophrenia also has negative symptoms, such as anhedonia, apathy, self-neglect, and social withdrawal; and cognitive symptoms, such as impairment of memory, learning ability, reasoning, and attention span. These negative and cognitive symptoms are sometimes treated with Cognitive Behavioral Therapy (CBT). Since cognitive symptoms are often the first to appear, early CBT treatment may sometimes, in milder cases, obviate the need for biological intervention.

CBT focuses on training the mind to change negative thoughts and actions. The therapist will often ask the patient to identify a particular fear. Perhaps, for instance, he has a paranoid delusion that his next-door neighbor is plotting to kill him. The therapist will then challenge the patient to produce evidence for this belief. Once they have agreed that there is no evidence, the therapist will teach the patient techniques for using this rational argument to respond to the delusion each time it arises, gradually eliminating it from the patient's mind. Similar techniques can be learned to deal with other symptoms. In severe cases of schizophrenia, both biological and cognitive treatments are generally used.

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