(2012-05-31) Recovering From Schizophrenia Without Medication

Recovering from Schizophrenia Without Medication | Mad in America. In February 2012, University of Illinois College of Medicine researcher Martin Harrow published, “Do All Schizophrenia Patients Need Antipsychotic Treatment Continuously Throughout their Lifetime? A 20-Year Longitudinal Study,” funded by the National Institute of Mental Health and the United States Public Health Service.

Harrow and his research team found that schizophrenia patients who were “not on antipsychotics [which include “typicals” such as Thorazine and Haldol, and “atypicals” such as Zyprexa, Risperdal, Seroquel, Geodon, and Abilify] for prolonged periods were significantly less likely to be psychotic and experienced more periods of recovery.”

Our 20-year data indicate that the subsample of SZ [schizophrenic patients] not on antipsychotics represent a moderate-sized group (30–40%) of SZ”; and many of them, according to Harrow’s results, achieve recovery without doctors.

It is my experience that those who have rejected medication and recovered are virtually all anti-authoritarians who question the legitimacy of authorities and resist those authorities they assess to be illegitimate ones.

Many mental health professionals, myself included, have seen psychotic relapse among diagnosed schizophrenics who have been “medication noncompliant.” But professionals ordinarily don’t compare this group to those “medication compliant” patients who also relapse or remain chronically psychotic. And most importantly, in their clinical practice, mental health professionals do not routinely see diagnosed schizophrenics who have recovered without medication and without doctors.

I had not heard about psychiatric survivors until 1994, when I was contacted by David Oaks, director of MindFreedom, a coalition of psychiatric survivor organizations from around the world

I have spent time with hundreds of treatment reform activists who were once diagnosed with schizophrenia but who have recovered without medication, and my experience is that they consider themselves lucky to have had family and/or friend support for their choice to resist psychiatric authorities

Harrow and his research team enrolled patients from two Chicago hospitals diagnosed with schizophrenia (as well as patients diagnosed with mood disorders with psychosis), so as to examine long-term outcomes

The majority of patients continued their antipsychotic medications, while about a third of them did not comply with medication treatment and stopped taking them.

The 20-year results showed that schizophrenia patients (and those patients with mood disorders with psychosis) who took antipsychotic medication regularly during the 20 years actually experienced more psychosis, more anxiety, and were more cognitively impaired and had fewer periods of sustained recovery than those who quit taking antipsychotic medications. (Intervention Roulette)

Among the schizophrenia patients who remained continuously on antipsychotics throughout the 20 years of the study, only 17% ever entered into any period of recovery during any of the six follow-ups. By contrast, among the schizophrenia patients who remained off antipsychotics after the two-year follow-up and for the remainder of the 20 years, 87% experienced...

At the 2-year assessment there were no significant differences in severity of psychosis between SZ on antipsychotic medications and SZ not on any medications. However, starting at the 4.5-year follow-ups and continuing over the next 15 years, the SZ who were not on antipsychotic medications were significantly less psychotic than those on antipsychotics.

Harrow concludes that those who stopped taking medication, while not initially different in severity of psychosis than the medication compliant group, are a “self-selected group with better internal resources associated with greater resiliency. They have better prognostic factors, better pre-morbid developmental achievements, less vulnerability to anxiety, better neurocognitive skills, less vulnerability to psychosis and experience more periods of recovery.”

Whitaker, in “Interpreting Harrow’s 20-Year Results: Are the Drugs to Blame?” notes: "If the drugs have long-term iatrogenic effects, wouldn’t that explain this surprising outcome?” Whitaker points out, “Nancy Andreasen [one of psychiatry’s most respected researchers] has reported that antipsychotic usage is associated with a decrease in brain volumes over time, and that this decrease in brain volumes is associated with an increase in negative symptoms and cognitive impairment.”

Harrow’s study does not challenge the idea that for those in the acute phase of a psychotic reaction, the short-term use of some tranquilizing medication can be helpful. Harrow’s results do challenge the idea that all patients diagnosed with schizophrenia or other psychotic disorders need to remain on psychiatric medication throughout their lives.