An international group of experts has concluded that, for patients with schizophrenia and related psychotic disorders, antipsychotic medications do not have negative long-term effects on patients’ outcomes or the brain. In addition, the benefits of these medications are much greater than their potential side effects.
“The evidence from randomized clinical trials and neuroimaging studies overwhelmingly suggests that the majority of patients with schizophrenia benefit from antipsychotic treatment, both in the initial presentation of the disease and for longer-term maintenance to prevent relapse,” said Dr. Lieberman. Moreover, whatever side effects that these medications might cause are greatly outweighed by their therapeutic benefits.
“Anyone who doubts this conclusion should talk with people whose symptoms have been relieved by treatment and literally given back their lives,” Lieberman added.
The studies also revealed that delaying or withholding treatment has been associated with poorer long-term outcomes. “While a minority of patients who recover from an initial psychotic episode may maintain their remission without antipsychotic treatment, there is currently no clinical biomarker to identify them, and it is a very small number of patients who may fall into this subgroup,” said Dr. Lieberman. “Consequently, withholding treatment could be detrimental for most patients with schizophrenia.” And while preclinical studies in rodents suggested that antipsychotic medications can sensitize dopamine receptors, there is no evidence that antipsychotic treatment increases the risk of relapse. While antipsychotic medications can increase the risk for metabolic syndrome, which is linked to heart disease, diabetes, and stroke, the study did not include a risk-benefit analysis.
Read more at: Benefits of antipsychotics outweigh risks, find experts
Full review http://sci-hub.cc/10.1176/appi.ajp.2017.16091016