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The more psychotic you are, the more benefit there is in taking antipsychotics

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firemonkee57

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The more psychotic you are, the more benefit there is in taking antipsychotics

Conclusions

The clinical implications of our findings may be as follows: we can expect the benefits of antipsychotics for patients with full spectrum of severity who are likely to treat for acute schizophrenia and for highly symptomatic patients with predominantly negative symptoms, and the severer the illness is at baseline, the bigger the benefits will be.
and

Towards the mildest end of the spectrum, judicious clinical consideration of trade-offs between benefits and risks of the antipsychotic treatment is required.


Discussion

What surprised me most about this paper was the use of data from old trials to develop and test this model. The included data ranged from papers published between 1993 and 1999 and the data would have been collected before this. This is not clearly identified in the paper. For the authors to only be allowed access or get access to 6 of the 97 trials is terrible. It is clear that this paper was supported via drug companies and their role in this is unclear, particularly whether the authors could only access certain data.

From a clinical perspective it is useful to know that those with the worst symptoms (either negative or positive) are likely to improve more as a result of prescribing an antipsychotic vs placebo. But the review only included three of the commonly prescribed antipsychotic drugs, and there was no discussion about optimum dosages. However, the outcome of these trials were measured at 6 weeks, so this does not help clinicians understand the longer term implications of antipsychotic prescriptions.


Initial severity of schizophrenia and efficacy of antipsychotics

Supported via drug companies/unclear whether could only access certain data/outcomes measured at 6 weeks. That combination doesn't sound good although it makes sense the milder your psychosis is the less difference an antipsychotic should make.
 
Kerome

Kerome

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It makes a general kind of sense, but I had only voices, no delusions and they still happily prescribed me a truckload of antipsychotics. It begs the question, how long does it take for this kind of information to filter down to the best-practice level where doctors actually use it every day?

Also I'm very suspicious of drug company involvement in this particular study. It sounds like the kind of thing they would want to control, and try to minimise the cases where doctors don't prescribe antipsychotics because of potential side effects and so on.
 
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firemonkee57

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I wonder how this research translates to people who are categorised with so called non psychotic diagnoses like borderline/paranoid PD/ schizotypal(although there may be brief psychotic symptoms) who are prescribed antipsychotics.
 
SomersetScorpio

SomersetScorpio

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I wonder how this research translates to people who are categorised with so called non psychotic diagnoses like borderline/paranoid PD/ schizotypal(although there may be brief psychotic symptoms) who are prescribed antipsychotics.
Well, I was diagnosed with psychotic depression - then re-branded as having BPD.
I can honestly say that when I was taking really high doses of anti-psychotics in my early teens, they didn't do anything for my delusional/paranoid thoughts. They just made me sleep a lot and so tired that I no longer gave a fuck if people were secretly filming me. :unsure:
 
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