Conventional psychiatric treatment for schizophrenia
Here is a glimpse at the outcome of standard neuroleptic drug treatment response as described by prominent clinical psychiatrists. These psychiatrists have provided valuable information to society. Their views are shared in the arena of evidence-based medicine. Their research is readily available to the public on well-known peer-reviewed databases such as PubMed. I encourage people to educate themselves and learn what they can about treatments considered of value, be they nutritional, pharmaceutical or otherwise.
66% of schizophrenic cases do not achieve a full remission of symptoms with neuroleptic treatment.1
33% of cases suffer “persistent cognitive disturbance and associated deficits of mood, motivation, and behavioural responses”.2
After a psychotic episode, 30-40+% of compliant neuroleptic-treated schizophrenics who have had a ‘positive’ response relapse within 1 yr.3,4
The highest suicide risk occurs in the first 5 yrs – the “critical period”.5 Fifteen percent of cases will successfully complete suicide.6
Best case scenario’s
In first episode (first-episode schizophrenia, FES) early intervention, with the lowest effective neuroleptic dose and adjunct psycho-education, relapse prevention, and psycho-social intervention we see the following outcome of treatment.7 These “patients are more likely to be taking medication at the end of three years… more compliant… more likely to be prescribed atypical medication… more likely to have returned to work or education… more likely to remain living with their families… less likely to suffer depression to the extent of requiring anti-depressants… commit less suicide attempts… less likely to suffer relapse and re-hospitalisation… less likely to have involuntary admission to hospital.”
A double blind study in the USA (The PRIME study) allocated prodromal schizophrenic patients to olanzapine versus placebo groups. After 1 year of treatment, researchers found olanzapine to be of no advantage over placebo; both groups experienced similar progressions and worsening of psychotic symptoms.8a
“There is emerging, but as yet inconclusive evidence, to suggest that people in the prodrome of psychosis can be helped by some interventions. There is some support for specialised early intervention services, but further trials would be desirable, and there is a question of whether gains are maintained. There is some support for phase-specific treatment focused on employment and family therapy, but again, this needs replicating with larger and longer trials.”8b
Patients commonly have poor quality of life and the majority remain dependent on parents and few have skilled or paying jobs.9
Drug withdrawal or discontinuation effects are another concern of note. 10,11
An alternate approach
In my experience, chronic patients have the potential to recover up to 40-60% with targeted orthomolecular therapy and early treatment less than 2 years post-onset is considered to help a more significant portion of schizophrenic patients.12,13
References
1. Shepherd M, Watt D, Falloon I, et al: The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. Psychol Med Monogr Suppl, 1989; 15: 1-46
2. Falloon IRH, Coverdale JH, Laidlaw SM, et al: Early intervention for schizophrenic disorders: implementing optimal treatment strategies in routine clinical services. Br J Psychiatry, 1998; 172(suppl. 33): 33-38.
3. Falloon IR, Shanahan WJ: Community management of schizophrenia. Br J Hosp Med, 1990 (Jan); 43(1): 62-66.
4. Bradford DW, Perkins DO, Lieberman JA: Pharmacological management of first-episode schizophrenia and related nonaffective psychoses. Drugs, 2003; 63(21): 2265-2283.
5. Byrne P: Clinical Review: Managing the acute psychotic episode. BMJ, 2007 (31 Mar); 334: 686-692.
6. Auquier P, Lancon C, Rouillon F, et al: Mortality in schizophrenia. Pharmacoepidemiol Drug Saf, 2006; 15(12): 873-879.
7. Agius M, Shah S, Ramkisson R, et al: Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team. Preliminary results. Psychiatr Danub, 2007 (Jun); 19(1-2): 10-19.
8a. Marshall M, Rathbone J. Early intervention for psychosis. Cochrane Database Syst Rev, 2006 (Oct 18); (4): CD004718.
8b. Marshall M, Rathbone J. Early intervention for psychosis. Cochrane Database Syst Rev, 2011 (Jun 15); (6): CD004718.
9. Linszen D, Dingemans P, Lenior M: Early intervention and a five year follow up in young adults with a short duration of untreated psychosis: ethical implications. Schizophr Res, 2001 (Aug 1); 51(1): 55-61.
10. Chouinard G, Vainer JL, Belanger MC, Turnier L, Beaudry P, Roy JY, Miller R. Risperidone and clozapine in the treatment of drug-resistant schizophrenia and neuroleptic-induced supersensitivity psychosis. Prog Neuropsychopharmacol Biol Psychiatry, 1994 (Nov); 18(7): 1129-1141.
11. Sultan S, Chouinard G, Beaudry P: Antiepileptic drugs in the treatment of neuroleptic-induced supersensitivity psychosis. Prog Neuropsychopharmacol Biol Psychiatry, 1990;14(3):431-8.
12. Pataracchia, R: Orthomolecular Treatment For Schizophrenia: A Review (Part One). Journal of Orthomolecular Medicine (JOM), 2008; 23(1): 21-28.
13. Pataracchia, R: Orthomolecular Treatment For Schizophrenia: A Review (Part Two). Journal of Orthomolecular Medicine (JOM), 2008; 23(2): 95-105.