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: