The Failure to Perform: Long-term Antipsychotic Treatment

antipsychotics drug side effects health topics schizophrenia schizophrenia treatment

The limitations of a randomized trial is that it cannot help us to understand what individuals bring to treatment risks and benefits. A critical new study by Harrow et al adds to previous data suggesting that long-term antipsychotic treatment results in poor long-term outcomes.

  • 139 patients were assessed at 2, 4.5, 7.5, 10, 15 and 20 years during hospital visits in Chicago. Of 70 diagnosed schizophrenics, 59 were followed for 20 years (and 11 for 15).
  • Group 1 was on medication at every follow up, Group 2 was on medication at some follow ups, and Group 3 was not on medication for any follow up.
  • At 4.5 years, Groups 1 and 3 diverged such at 76% of those medicated were actively symptomatic (hallucinations, delusions, disorganized thought) while only 27% were in Group 3. At 20 years, these figures were 56% and 24% respectively.
  • Of those without symptoms at a minimum of 4 of the visits, 76% were in Group 3.

This paper raises questions about efficacy of a treatment so rife with morbid side effects, and about the urgency to cultivate tolerance for non-medication treatment in the face of active symptoms. It can no longer be considered clinically justifiable to maintain patients on chronic medication treatment – not for the individual and not for society. As Dr. Steingard states:

this is an approach that does not place prevention of relapse as  paramount but in balance with other considerations including personal choice and the many consequences associated with long term exposure to these drugs.

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About Dr. Kelly Brogan

KELLY BROGAN, MD, is a holistic psychiatrist, author of the New York Times Bestselling book, A Mind of Your OwnOwn Your Self, the children’s book, A Time For Rain, and co-editor of the landmark textbook Integrative Therapies for Depression. She is the founder of the online healing program Vital Mind Reset, and the membership community, Vital Life Project. She completed her psychiatric training and fellowship at NYU Medical Center after graduating from Cornell University Medical College, and has a B.S. from M.I.T. in Systems Neuroscience. She is specialized in a root-cause resolution approach to psychiatric syndromes and symptoms. Learn More