Harrow 2012 Do all schizophrenia patients need antipsychotic treatment continuously throughout their lifetime?

[Altostrata]

The answer is no, says a 20-year study of 139 patients. Those off medications did better overall and did not have a higher rate of relapse.

 

Psychol Med. 2012 Feb 17:1-11. [Epub ahead of print]

Do all schizophrenia patients need antipsychotic treatment continuously throughout their lifetime? A 20-year longitudinal study.

Harrow M, Jobe TH, Faull RN.

 

Source

 

Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.

 

Abstract http://www.ncbi.nlm.nih.gov/pubmed/22340278

 

BACKGROUND:

 

The prevailing standard of care in the field involves background assumptions about the importance of prolonged use of antipsychotic medications for all schizophrenia (SZ) patients. However, do all SZ patients need antipsychotics indefinitely? Are there factors that help to identify which SZ patients can enter into prolonged periods of recovery without antipsychotics? This 20-year longitudinal research studied these issues.

 

Method A total of 139 early young psychotic patients from the Chicago Follow-up Study, including 70 patients with SZ syndromes and 69 with mood disorders, were assessed, prospectively, at the acute phase and then followed up six times over the next 20 years. Patients were assessed with standardized instruments for major symptoms, psychosocial functioning, personality, attitudinal variables, neurocognition and treatment.

 

RESULTS:

 

At each follow-up, 30-40% of SZ patients were no longer on antipsychotics. Starting at the 4.5-year follow-ups and continuing thereafter, SZ patients not on antipsychotics for prolonged periods were significantly less likely to be psychotic and experienced more periods of recovery; they also had more favorable risk and protective factors. SZ patients off antipsychotics for prolonged periods did not relapse more frequently.

 

CONCLUSIONS:

 

The data indicate that not all SZ patients need treatment with antipsychotics continuously throughout their lives. SZ patients not on antipsychotics for prolonged periods are a self-selected group with better internal resources associated with greater resiliency. They have better prognostic factors, better pre-morbid developmental achievements, less vulnerability to anxiety, better neurocognitive skills, less vulnerability to psychosis and experience more periods of recovery.

[Altostrata]

Robert Whitaker's commentary:

 

Interpreting Harrow’s 20-Year Results: Are the Drugs to Blame?

[compsports]

You know the usual spin doctors will be out in full force.

 

It doesn't matter what the facts are. Harrow could have a 50 year report and it wouldn't matter.

 

Meds are the solution come heck or high water.

 

Sorry for my cynicism and negativity.

 

CS

[Shanti]

Very nice study and I find this to be true. I'm doing fine without antipsychotics now. That antipsychotics were horrible and made me a total mess. I feel sorry for all the sz patients on antipsychotics all their lives.

 

I can understand your cynisism CS. It's sad but true.