Tag: long-term antipsychotic treatment
There is a lack of consensus in the definition of ‘relapse’ across randomized controlled trials of antipsychotic maintenance treatment for schizophrenia and psychosis.
The annual meeting of the UK’s Royal College of Psychiatrists is in full swing at the moment in London. The conference will again not be debating important new findings about antipsychotic drug treatment. Two years ago the conference organising committee rejected a suggestion to discuss this issue. This year I proposed a similar symposium. The proposal was rejected again. I am extremely concerned that the Royal College conference organising committee do not appear to be aware of the importance of this issue.
This week Live & Learn launched a research study on the experience of people labeled with mental disorders who have tried to stop taking psychiatric medications. This project -- the Psychiatric Medication Discontinuation/Reduction (PMDR) Study -- aims to understand the process of coming off psychiatric medications in order to better support those who choose to do so. The study seeks to answer the question: What helps people stop their psychiatric medications? What gets in the way of stopping?
The writings of Pies and his colleagues, I believe, provide a compelling case study of cognitive dissonance. Cognitive dissonance arises when people are presented with information that creates conflicted psychological states, challenging some belief they hold dear, and people typically resolve dissonant states by sifting through information in ways that protect their self-esteem and their financial interests. It is easy to see that process operating here.
For a long time I have felt that there just isn’t a good enough and long enough study on the pros and cons of long-term antipsychotic treatment versus reduction and discontinuation in people who have psychotic disorders, including those who are classified as having schizophrenia. Moreover, there are increasing reasons to be worried about the effects of long-term treatment with antipsychotics. I put this case to the UK’s National Institute of Health Research recently, and proposed that they fund a trial to assess the long-term outcomes of a gradual programme of antipsychotic reduction compared with standard ‘maintenance treatment.’ The NIHR agreed that this was an important issue, and that a new trial was urgently needed. The RADAR (Research into Antipsychotic Discontinuation And Reduction) study officially started in January 2016.