Better off without antipsychotics?

Unusual Beliefs
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This is an article that I just saw on advocacy. I don’t know if this works for some or not?
Better off Without Antipsychotics?
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(Sept. 8, 2014) It is not news that some psychiatrists think some patients are better off without antipsychotic drugs, writes Dr. Torrey in Psychiatric Times (“Better off without antipsychotic drugs,” June).

“It has been known for a century that some individuals with schizophrenia recover and do not need ongoing treatment,” he writes.

Citing two studies, Dr. Torrey illustrates why the key word is “some.”

In 1939 Dr. Harry Stalker published outcome data from 3551 patients with schizophrenia that showed 21 percent were in “complete remission and another five percent had improved or were living at home.”
A 1978 study by Dr. Joseph Stephens shows similar results. Stephens found that after 10 years, “29 percent of patients with schizophrenia were in complete remission.”

These scenarios “view the glass as half full,” writes Dr. Torrey. “But it is equally important to look at it as half empty … It is important to note that antipsychotic medications improve the quality of life for most, but not all, patients with chronic schizophrenia and most of them will require medication for many years.”

Torrey again points to Stalker’s 1939 research that also found 67 percent of the patients with schizophrenia showed little to no improvement and five percent had died. He directs the audience to later research from Stephens showing similar results.

“So yes, it has been clearly established for many years that some patients are better off without antipsychotic drugs,” Torrey writes. But in recent years, “advocates have interpreted this to suggest that most individuals with schizophrenia are better off without antipsychotic drugs.”

But, Torrey argues, during a time when approximately 1.3 million people with schizophrenia remain untreated, we need look no further than our homeless shelters, bus stations and jails and prisons to determine whether these individuals are better off without treatment

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The very few people I’ve ever seen make it without meds… have a very good support network, a lot of resources available to them and the money to stay in contact with those resources.

The people with no support… no family… no resources… don’t seem to be doing great with out meds.

I realize I’m not having the best day today… so I’m trying not to overreact…

But those anti-med people really get under my skin. Sure it takes time, energy and work to find a combination that puts me back on track… but every time I’ve quit my meds… I’ve ended up in hospital.

I’ve been med compliant for the longest stint ever in my life just this past year… and THIS is the year I have enough concentration to go to school and do well… this is the year I’ve been able to get the better job. This is the year my memory has been coming back to me… this is the year I haven’t gone completely manic.

My concentration is a little off today too…

When I wasn’t med compliant… I was homeless, I was rabid, I was eating out of dumpsters…

It seems like this Torrey is saying that’s better then being medicated?

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i had a serious discussion with my psychiatrist on antipsychotic use - I asked her if one day soon I will be able to lower my Risperdal dose and possibly go without antipsychotics - she basically said that she does not recommend that I go off of antipsychotics, my mood will shift too much and I will develop psychosis again, she also said that my brain has adjusted to these drugs. I am a bit disapointed but she could be right - I do not think I would last too long without antipsychotics

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@SurprisedJ , that is why he used the words wisely by saying some (key word). I wish they knew who are the some? There is no way to know unless they tried to go off medication. I guess everyone has a point. It works for some and it may not work for others. The some may be very few. Like you said that they have support. Financial stability, loved ones, family who supports them and stays home to be with them. Yes, not everyone has the means to do that.
@Wave, the antipsychotics have terrible side effects. Worst is weight gain for a lot of people.
Wishing everyone the best. Positive thoughts and hugs.

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How many anti-psychotic medications were in use in 1939?

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I know I could not make it without the APs? I too would be homeless again, and I consider my support structure to be superb.

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I didn’t even think there were antipsychotics till 1960. But this is an article I stumbled upon. So I just put it out there for people.

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I think Torrey is saying that most people with psychosis are better staying on antipsychotics.
Thomas Insel takes a more nuanced view .

It appears that what we currently call “schizophrenia” may comprise disorders with quite different trajectories. For some people, remaining on medication long-term might impede a full return to wellness. For others, discontinuing medication can be disastrous. For all, we need to realize that reducing the so-called “positive symptoms” (hallucinations and delusions) may be necessary, but is rarely sufficient for a return to normal functioning. Neither first nor second generation antipsychotic medications do much to help with the so-called negative symptoms (lack of feeling, lack of motivation) or the problems with attention and judgment that may be major barriers to leading a productive, healthy life.

http://www.nimh.nih.gov/about/director/2013/antipsychotics-taking-the-long-view.shtml

The problem is who fits into which category and the consequences of getting it wrong.

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I found an article that said:

In 1951, Laborit and Huguenard administered the aliphatic phenothiazine, chlorpromazine, to patients for its potential anesthetic effects during surgery. Shortly thereafter, Hamon et al. and Delay et al. extended the use of this
treatment in psychiatric patients and serendipitously uncovered its
antipsychotic activity. Between 1954 and 1975, about 15 antipsychotic
drugs were introduced in the United States and about 40 throughout the
world

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Yeah that’s what I’d read too…mid 1950’s…

I do believe however that it is possible to recover from schizophrenia. I myself though I do take a fairly low dose of Abilify do not rely on meds to keep my symptoms in check. When and if they return I do not run to the doctor and have my dose upped. I am finding that the more I come to terms with the nature of my symptoms the easier it’s becoming to simply not let them consume my mind…I don’t freak out when they make the odd comeback and I’m finding that the more I understand them and am familiar with how they effect me the more I am able to head off a relapse of symptoms by just keeping a cool head about it.

This is why every time I hear on here something like “Better up those meds!” I have a bit of a sigh and maybe even a groan…I understand that this is my circumstance and that is different than others with this illness and some may have it bad to the point where medication may be the number one tool in their fight against Sz right now. But for me I’ve found that understanding it and it’s effect on me has been far more effective for me than freaking out about it and having my dose upped if my symptoms happen to be returning.

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Here’s a pretty good article from NIMH about the effectiveness:

http://www.nimh.nih.gov/about/director/2013/antipsychotics-taking-the-long-view.shtml

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Heres a 2014 scholarly article from Psychological Medicine (Its reproduced by Mad in America):

Results. At each follow-up assessment over the 20 years, a surprisingly high percentage of SZ treated with antipsycho-tics longitudinally had psychotic activity. More than 70% of SZ continuously prescribed antipsychotics experiencedpsychotic activity at four or more of six follow-up assessments over 20 years. Longitudinally, SZ not prescribedantipsychotics showed significantly less psychotic activity than those prescribed antipsychotics (p<0.05).

Conclusions.The 20-year data indicate that, longitudinally, after thefirst few years, antipsychotic medications do noteliminate or reduce the frequency of psychosis in schizophrenia, or reduce the severity of post-acute psychosis, althoughit is difficult to reach unambiguous conclusions about the efficacy of treatment in purely naturalistic or observationalresearch. Longitudinally, on the basis of their psychotic activity and the disruption of functioning, the conditionof the majority of SZ prescribed antipsychotics for multiple years would raise questions as to how many of them aretruly in remission.

Anti-psychotics are also known to shrink the brain. The higher the dose of AP the more the brain loss.

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antipsychotics turned my paranoia into hallucinations both visual and auditory. i think most schizophrenics need medications what i disagree with is labeling all psychosis as schizophrenia something all my doctors have done. sometimes you are psychotic and bipolar or just schizoaffective for instance. i think schzioaffective people could live a much better life with no meds. these meds are not safe, cause brain damage and brain shrinkage, tarditive dyskinesia and in the case of risperdal pituatary gland tumors.

is sad that all schizophrenics are prescribed antipsychotics if the hallucinations dont effect someones life then this brain damage cost benefit analysis should be done

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I know from my personal experience that when I go off my medication I become very ill and end up in the hospital. This isn’t opinion, it’s been proven time after time over almost 30 years. It took a considerable effort for me to start taking medication regularly and takes a considerable effort for me to remain on medication.

I don’t know the details of the study, I only skimmed it, but I do not believe at all that schizophrenics are better off without medication.

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I have never seen anyone do well without meds save for John Nash, and he did good work but he didnt do it well. He was batshit insane and mostly dysfunctional whilst he was scribbling away on chalkboards. He came across as crazy. He is a good example- he was apparently called "the phantom of [somewhere in princeton] hall and was recognized for his strange clothing, I heard he wore purple sneakers every day. He was basically given a place to do what he felt like all day, in this case the library of an Ivy league school. He didnt go much else but did get in trouble when he wasnt scribbling crap I will never be able to understand because I am not studying math.

I on the other hand am also a university student but I do not come across as insane, in fact people think I am outstandingly healthy and full of confidence. People ask me for my number to be study buddies every semester since I quit sitting the the back and being silent and got on medication. It happened on Thursday actually. I do tell some people about it but I tell them that I am a recovered schizophrenic so they know I am not hearing voices telling me to kill them.

“better off” is too vague and would never be used in a study. I’m a psych major, saying someone is “better off” without any other description of what that entails will earn you a D if you are lucky, but you would most likely fail the paper you wrote that in.

I guess he means that they are NOT “better off” without treatment, as he is saying to go to the worst parts of cities to find them (prisons, jails, wtf man) he didnt say go audit an honors psychology class and try to tell which one is the paranoid schizophrenic. He didnt say go to the school’s gym and look at the most muscular young men and figure out which one is schizophrenic.

I know I am “better off” with medication, I was self-destructive without it.

Anti-psychiatry is just one of my pet peeves. I think practicing anti-psychiatry should be equated to going to war without wearing armor or even wielding a weapon.

and same here, every time I have had a med adjustment that didnt involve more Geodon, I have seriously lost my ■■■■ and required hospice from my parents. It has been almost a year, but they had to take care of me like I was four years old, a four year old who is overweight with muscle, trained in hand to hand combat and clinically insane. Not “better off” by any means.

But if you are an honors student who is in excellent physical health, has a social life, and doesnt abuse substances, and you aren’t on medication, you must have the least severe case of schizo I have ever heard of.

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Meds are not good to stop taking. If people stop their meds, then they end up in the hospital/psych ward.

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True, it happened to me too, that whenever I stopped my meds I ended up in hospital, or at least nearly always in crisis. Its better to live with the side effects than with the symptoms at their strongest. (Try telling that to me because I so often wanted to go off meds! But it isn’t worth it)

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The question for me is do people lapse into psychosis off them because their bodies have got used to the medication and they are experiencing withdrawal? If so how long being on a med before one can say when stopping the return of psychosis is a withdrawal effect.
I do know I was off antipsychotics from late 82 to mid 98 but on lithium and there are debates as to whether it has antipsychotic properties. During that time I was officially schizoaffective with a few unofficial suggestions of bipolar. I was not consistent in taking the lithium but If It had antipsychotic properties as well as mood stabilising this could explain why I never had an acute withdrawal response.

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While my kids r still living at home I’ll stay on them…or until my parents either die or r too infirm to b involved in my care. Personally I don’t think I need them, so long as I don’t watch tv or music videos. I stay on them grudgingly for now because my son is too young to take care of himself and it’s not my children’s responsibility to take care of me. When they r older, all bets r off. I am only on a maintenance dose anyway and all this particular one does is make me feel like a zombie. I hate Aps with a passion. Have I been psychotic? Yes I have but I think I would e come out of it without Aps regardless. Experience helps me. Anti psychotics do not.