Non sedating anti psychotics
However, there is general consensus that there are some individuals who will recover and not need medications long-term.In fact, there is even consensus that some can recover without drugs; the dispute is over numbers.For me, this raises an urgent question about initial treatment.Doesn’t it make sense to try to capture all of those individuals who might get through a psychosis without drugs?However, this approach has not been carefully evaluated within the mainstream of psychiatry.
One of the most compelling reasons why these authors support long-term care is related to the relapse data: when one is started on these drugs, the relapse rate is higher when they are stopped than when they are continued (at least over the first two years).
The final paper is a thorough literature review of studies that analyzed the association between duration of untreated psychosis — and in this paper, treatment appears to be synonymous with initiation of drug — and various outcomes.
They found that those started on drugs earlier had a more robust reduction of psychotic symptoms.
Doesn’t it make sense to invest heavily in interventions that do not rely on drugs as a first-line treatment?
At least then we can protect that group — be it 20% or 80% — from the cycle of relapse that seems to begin once the drugs are introduced.
Goff and colleagues only devote one paragraph to this topic and cite three papers.