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Is non-pharmacological treatment an option for certain schizophrenia patients?

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firemonkee57

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Is non-pharmacological treatment an option for certain schizophrenia patients?

Abstract
BACKGROUND:

Schizophrenia treatment has been debated at length and presently pharmacological treatment is being advocated as the most beneficial for patients. However, research has shown contradictory results regarding the suitability of pharmacological treatment for certain groups of schizophrenia patients.
METHODS:

The present review discusses results from the literature indicating good outcomes only for patients who adhered to prescribed pharmacological treatments. It also describes studies favoring non-drug treatments in certain schizophrenic patients.
RESULTS:

The authors described two groups of patients where the long-term use of neuroleptics may be useless, if not harmful. The first group comprised schizophrenic people with a single psychotic episode and therefore very good prognosis. In their case, the prolonged use of antipsychotics would not be beneficial due to pharmacological and social (stigma) side effects. Further research is warranted to identify and investigate biological, environmental, and psychological factors associated with single-episode schizophrenia. The second group comprised ultra-resistant schizophrenic patients. In their case, in the absence of a therapeutic response in acute episodes or aggressive behavior, clinicians should use short episodes of treatment with benzodiazepines or other sedative medications such as mood stabilizers.
CONCLUSIONS:

The present paper attempted to answer the important question as to whether all schizophrenic people should be treated with antipsychotics for the same good prognosis. The authors have provided solutions for better outcomes in a greater number of patients using alternative treatment after identifying schizophrenic patients who should not receive neuroleptic treatment. Suggestions for future research are also discussed.

Is non-pharmacological treatment an option for certain schizophreni... - PubMed - NCBI
 

cpuusage

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i think there is a lot of evidence to suggest that people could be far better helped, especially in first episode psychosis to long term successful medication free life. i'd go as far as to say the vast majority could, with appropriate support.

Of course it's a different story often when people have been drugged for years.

Some people are likely best helped with medications, but they should still get proper support as well, proper psychological/emotional & social support.

i think different approaches should now be being used, instead of sticking everyone on drugs.
 
coldwater00

coldwater00

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It's a battle between what people want and what is seen as being best for that person. Regardless of whether first episode patients want drugs or not, the majority are encouraged to take them. Early Intervention teams, in conjunction with NICE guidelines on how to handle these patients, advocate neuroleptic usage for a minimum of 3 years to prevent relapse. In theory, that seems ok as you'd think people would be encouraged to withdraw after their 3 years with the team is up.. That's not the case though, the majority are discharged to other secondary services and continued on the medication or are sent back to primary services and parked on sedating medication for years to come, without appropriate support from any other angle. It's easy to see how people become chronically dependant on the drugs.
 
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Joethejo

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They say these drugs are not physically dependant but having come off Clozaril after 17 years I would say they definately are. Surely if the definition of physical dependency is physical pain on withdrawal then the companys are lying to us. And the thing is with me it was not a choice it was take this drug or stay in this highly restrictive hospital enviroment. Coerction in the extreme and it turns out that that hospital misdiagnosed me anyway. If I had had any therapy or even someone looking at t he timings of my episodes the ensuing 17 years of living with not being able to think not being able to move hardly and turning into an elephant might not have happened.
Sorry for the moan but I'm feeling distinctly like a human guinea pig after they have finbished experamenting on it at the mo. :(
 
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firemonkee57

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Re those with one episode of psychosis/schizophenia- I can see an argument for tapering off antipsychotics if no further signs of psychosis/schizophrenia occur over a certain time frame, while monitoring for possible signs of relapse off medication.
There could be those who are doing well and only having one episode precisely because for them the medication is working well in treating their symptoms.

Currently a way for reducing side effects would be to give doses at the lowest dose that has a therapeutic effect, and for pdocs,as much as possible, to avoid polypharmacy especially prescribing two different medications from the same class.
 
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