Wednesday, 18 March 2009

Treating schizophrenia without drugs

There's no doubt the discovery of anti-psychotic drugs was a breakthrough. Previously people with schizophrenia could expect hospital confinement and little in the way of actual treatment. Today's anti-psychotics are safer than the early versions, but they still have serious side-effects and because their prescription for psychosis is so routine, there's a danger that some people, who might otherwise recover with psychological help only, are taking them unnecessarily.

This is a difficult area to study because any research that denies patients the drugs they need will rightly raise alarm bells. John Bola and colleagues scoured the literature looking for studies where drug treatments for schizophrenia were delayed for a set period of time, in conditions where patients received plentiful psychological and social support. They found five such studies involving 261 participants with schizophrenia, many of whom were not given anti-psychotic medication immediately. Their outcomes were compared between one and three years' later with patients who were treated with drugs straight away.

These studies included the Rappaport Agnews State Hospital Project (pdf), the Soteria project and Soteria Bern Project (pdf), the Finnish API Project and the Cullberg Parachute Project. Across all these studies, the psychosocial treatments varied, but in general patients were provided with a community-based therapeutic milieu with ample social support, a relaxing environment, and with family therapy often also included.

Among the patients for whom drug treatment was delayed, about one-third actually ended up recovering without needing to take medication at all, and longer-term, their outcomes tended to be superior to those patients who were treated with drugs immediately.

Bola's team said these findings show that in a residential care context (where medication can be prescribed swiftly if needed) it is possible to research drug-free approaches to schizophrenia in a safe and ethical way. And they added that that the findings point to a sub-type of schizophrenia that is associated with spontaneous recovery, in contrast to the trend for deterioration shown by the majority of patients.

"The above cited studies at least highlight the fact that no disadvantages and several advantages have been noted with no or a low-dose anti-psychotic medication in combination with psychosocial interventions for first episode schizophrenia spectrum patients," the researchers said.

Previously on the Research Digest: "Caring for psychotic patients with maximum kindness and minimum medication".
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ResearchBlogging.orgJR Bola, K. Lehtinen, J Cullberg, L Ciompi (2009). Psychosocial treatment, antipsychotic postponement, and low-dose medication strategies in first-episode psychosis: A review of the literaturePsychosis, 1 (1), 4-18

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

29 comments:

  1. Jonathan Meline7:21 pm

    I was diagnosed with schizophrenia and now if I had an evaluation they could not label me this way. I have found that telepathy is something I was misunderstanding I thought that not only the mind but heart and soul were able to be known, turns out the cause of schizophrenia is believing people can know more about you than just your mind (thoughts) so telepathy helps a great deal. Telling people they are delusional for hearing voices needs to be recognized as 'wrong' for I have confirmed with people that they can hear my telepathic voice and they can use them too. The part where people get confused is that there are people that are using telepathy that are imitating people; purposefully throwing people off of the truth about telepathy. I can prove it jontelepathy@ymail.com

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  2. Steve Page5:07 pm

    Jonathan, unless you're a troll, you need help.

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    1. steve and zidus they belong on Crazy boards forum, pro med and ignorace is bliss. I don;t appreciate reading their useless and thoughtless contribution and confirming the attitude that we get and the stigma and limited perspective that everything is about the "medication"....

      shouldn;t promote that place, wonder if the site will get new members who like to talk about their meds and anything to desolve the myths of psychiatry get bashed, attempted humiliation and removed. They use this troll idea too, but I think steve got his definition wrong when using it against Jonathon who'sm experience I relate to to some extent....

      Just gotta watch getting too absorbed into ideas about telepathy without grounding and centering the mind. Maybe then you can identify the deviant entities that talk lies or have a limited perspective of reality according to us mortals.

      clairvoyants are trained to deal with this phenomenal and learn to ground themselves

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  3. Anonymous1:07 am

    If people tell you lies, if corruption is everywhere and it is left to you the patient to sort it out, then theres a problem. Eventually you stop getting mad and you just go "mad"
    Hamlet is an unfortunate example, Im sure the decieving king would have prescribed a long dose of tranquilizers had he had them and his mother would have said nothing. For this problem chemistry is just as much a bluff. And bluff they will.....for a richer, more powerful than you, more respectable, easier life.

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  4. Well, I am a recovered schizophrenic w/o meds (antipsychotics) although I still take antideppressants. I have been symptom free for many years but I feel a like failure. I think modern psychiatry is intimidating and abusive and can actually hinder a person's progress. Psychiatrists are on a power trip and like to wield power over people. I am 51 and unmarried as most women would not marry someone who is poor and has mental problems. Neither would they date or marry artists as artist's are also poor.

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    1. Anonymous3:35 am

      You're still a valuable dating partner to someone I bet- check out ourtime.com -for note- I'm not spam - my grandmother used the site.

      Ty

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  5. Jonathan Meline, schizophrenics like you are the reason why "normal" people think we're all axe murderers. Telepathy? As one schizophrenic to another, I have two words for you: B*tch, please. Either do what this "article" suggests and find alternative treatment, or take your goddamned pills and stop giving us all a bad name. Word.

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  6. Anonymous8:08 am

    Doctors made me feel like I had done something very wrong and I was treated very poorly when I was in hostpital. I felt like a criminal. The Doctors never smile and one Doc had to leave the room to grab a form from another room and took her handbag with her. Kinda sad really. Anyway, I hope people feel supported nowadays with new treatments etc, this was over a decade ago.

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  7. Anonymous6:52 pm

    im the type of person who hates to take pills...i shudnt have to pop pills jus to feel normal...thats how ppl get addicted to pills...im glad i found thi article i may have to try this to see if it will help...someone told me vitiman c will also help idk if thats true but i will deff look into this treatment!!!!

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    1. Anonymous11:32 am

      many schizophrenics have been treated successfully with mega doses of specific vitamins nutrients and amino acids such vitiman c just check out optimum nutrition for the mind by patrick holford

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  8. Hello, my name is shane

    I was trapt in "limbo" type place and medication didnt help. I was unable to connect to reality and felt i was being spiritaly attacked from everywhere. Being around friends, and having a stable loving home i slowley got back into reality and then i felt normal again. I felt i was loosing control again, a horrible horrible place to be, and this website and your reasearch gave me a beter understanding. Its very late, and theres no-one i can talk to right now. I was just trying to feel balanced and could not go to sleep.


    The last place i want to be is a mental hospital. Ive been in pehms and it was extreemly out of control there I could literally say i was insane.

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  9. I fully recovered from schizophrenia in 1977 after 4 years of treatment. I couldn't continue to live while on the agonizing anti-psychotic drugs and so I quit the support program and weened myself off the drugs gradually in order to avoid a withdrawal relapse. Since then I have lived a very full life and I am now retired from my career in business. I married, traveled the world exstensively and enjoyed a part-time career as a musician and spent time in the 1980's advocating for psychiatric self-help reform. I attribute my recovery to my acquired ability to finally comprehend the nature and cause of my illness. First off, I stopped smoking pot. That's a must. Then I discovered the theories of Carl Jung regarding "synchronicity". Many schizophrenics have told me that in addition to "voices" they also (and often more importantly) experienced periods of constant profound synchronicities which were just to bizarre to dismiss as mere coincidence. This certainly happened to me at age 19 (and still sometimes does) and the experience then caused me to set off on what then became a delusional metaphysical quest (as depicted in the movie "A Beautiful Mind). However, the initial experience was real and the problem only ocurred when I was inspired by the initial experiences to delve into a "quest" to find more metaphysical omens. You can't make it happen! You go crazy trying. Jung theorized that synchronicity (numerous meaningful coincidences) is a real phenomenon experienced by some people and he felt that it was linked to Einstein's Theory of Relativity, but to Einstein's elements of time, space and matter he added "spirit". They are all inter-connected. Freud vehemently opposed Jung's theory as does modern psychiatry but by dismissing the phenomena solely as symptoms of "delusion" sufferers tend to embrace the "quest" all the more and therefore suffer the resultant delusional relapses. Once I learned that such an esteemed psychiatrist as Jung gave credence to the idea of "synchronicity" I stopped worrying about what the run-of-the-mill psychiatrists thought and dumped them all. Jung, having justified my point, enabled me to relax and stop trying to "see" more metaphysical events. I won't elaborate here but very strange episodes do still occur in my life but I now just take it in stride.
    During my "heightened" states I also heard very pronounced voices which through self-will I learned to filter and reject anything potentially destructive. Admittedly, it was while on medications that I realized that I would have to over-rule the "voices" once drug free. I'm certainly not totally against anti-psychotic drugs for short term use. Over active dopamine activity does acompany "voices" and the delusions which result from the "metaphysical quest".
    I've had a great life. Schizophrenia can definitely be handled without having to spend a shortened lifetime on drugs. Now I'm looking forward to my retirement years.

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    1. Just wanted to say, reading through your account, you are a true success story of what I call recovery. All these scientific papers that proclaim the use of drugs to help ppl recover from mental illness haven't a clue. I think stories like your own give just hope to those looking to recover from schizophrenia. I also believe developing realistic coping strategies like you've detailed here are the best way forward.

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    2. Anonymous5:39 pm

      I can identify with what you've said, as I too have experienced many, many situations of synchronicity but haven't understood why they happen. To
      give one example, as I was reading a chapter on a spider, a spider actually crawled across my book. No, I wasn't seeing things! Or more recently I saw a word on a van, and two minutes later, the same
      word"Ask" came up in a book i was reading. My son though has been diagnosed with Schizophrenia and has been on antipsychotic drugs for the past five years, but he still hears voices. In fact,he started to hear voices after he started taking meds. Now i want to see if I can get him off them and try other ways. These emails above give me hope. This website too.

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    3. I recently responded to an email from a man concerned about his son and thought my response might be of interest to others as well, being that it is an extension of my original post:
      Dear Mr.-----
      Thank-you for writing. It sounds like your son is fairly high functioning, which of course, is an advantage in that hopefully he can come to an understanding of his own mental aberrations. Apparently, medications of today do not necessarily have as many terrible side effects as the ones from decades ago and therfore the need to get off of them quickly is perhaps not as urgent. I would advise a gradual reduction of the dosage along with proper nutrition and sleep and a complete abstention from any and all recreational drug use except for perhaps some light social drinking. Any final step to completely eliminate the medication should be monitored closely. I would also advise that religion be viewed in pragmatic, non-devotional terms. In other words, the practical, philosophical benefits of religion can be embraced, but the other-worldly "miraculous" elements should be down-played and attributed to the primitive times in which religions were first founded. (That does not diminish their worth) That being said, it is my experience that schizophrenic phenomena such as "voices" and "synchronicity" are very real and it is a mistake for psychiatrists to merely negate, trivialize and suppress these manifestations without proper specific counselling. It's very insulting to the patient and only makes them want to delve deeper in defiance. These phenomena have a basis in a science which we do not yet understand - as Jung implied. Through these types of manifestations I actually foretold the Iranian revolution of the late 70's as well as the contoversial death of the first pope named John Paul and made public these notions in musical performances. However, it was important to my health to attribute these occurences to science rather than religion and to just take it in stride. I do believe in a higher power but it helps me to see God as a force which understands mankind's imperfect attempts to explain "Him" through our religions. The key to being able to eliminate all medication is this ability to understand and rationalize the schizophrenic manifestations, both without fear and without awe and exuberance. Also, the manifestations should decline in number and gravity with the aging process. I hope my views and experiences prove helpful to you and your son. I wish you all the best and if you have any other questions or comments don't hesitate to write.
      Sincerely,
      F. J. Seraf
      www.soundclick.com/frederickserafim

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    4. Anonymous8:05 pm

      Hi F.J. Seraf I am really interested in what you have written in here because I want to help my brother who has schizophrenia and right now he has an episode but he refusing to take any medication so I am tying to find alternative way to help him. But I live far away from him so it is very difficult for me to help him.
      Can you help me to point him to right direction and also tell me how to talk to him.

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    5. Anonymous9:24 pm

      Hi F.J. Seraf, First of all, I appreciate the kindness and candor you have shared on this site. I too am healing from schizophrenia without the use of medication. I grew up in a very difficult environment. I had a major break down in my late teens and several episodes throughout the years. I am in my mid 30's and I maintain a "normal" life. As for voices, mine remain with me to this day. I am an educator (and I am well educated), I have a family, a marriage, a healthier lifestyle than many; really. I am also a devout Christian. It wasn't until I discovered the love that God has for us that I discovered I could love myself. With this discovery; I have learned to co-exist with my voices. While I attribute my education to be a primary cure; I know that my spirituality carries me through the entire healing process. Without it, I know that I would have experienced a much darker side of the illness which might have potentially lead to self harm. I do not push my beliefs on others and I teach equality and acceptance of each of our own uniqueness. I understand your position on religion, as it is easy to attribute the delusions to something otherworldly and that might perpetuate an unhealthy relationship with the illness; however, it is important to allow each to find their way to healing. For me, Christ is a very valuable part of the process and continues to provide enduring hope. Again, thank you for sharing your healing process; I hope that others will find peace in my story as I have found in yours. I also think you might appreciate this Ted Talks: http://www.ted.com/talks/eleanor_longden_the_voices_in_my_head.html

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  10. Steve & Zidus, shame on you on being so disrespectful! You can write trash about other people on your own websites; please save this space for useful commentary.

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  11. I in Hongkong, I read much info on nt relying on drugs , my brother had problem for 10yrs , lately hospital" lock "him up again

    I hate them , now seem like a puppet manipulated by gov doctor

    they won't ez to "release" patients , afraid affect their job if patients "chop ppl " outside :'(

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  12. adaptation makes for the increased risk when coming off the drugs, so why can't a "professional" depict how long it will take for the brain to adapt back to normal.

    It is so frustrating dealing with these idiots They pull strings to arrive at symptoms like persecutory delusions since I had a problem with my family adopting pharmacuetical attitude toward me and using psychiatry as a scape-goat anytime I challenged them or spoke out, so they use it to keep me silent and agreeable but when I come off the drugs I get flooded with re-evaluating my life since dopamine has returned to optimal to have outlook on life. So I actually get this thing like PTSD that leads to sleep deprivation.

    Why isn;t there more literature about sleep deprivation being prerequisite for disorganised states, its infuriating and yeah I'm angry but a doctor will assume that is part of my illness as an agitated text bookk case without insight. Yeah this insight thing is a real problem, psychiatrists have very limited insight into the nature of psychosis especially if a patient has insight that they will recover without the drugs they force them into compliance and a treatment order for years until a pprofessional considers they can look after their medication. As for legal aspect the jury is using the medical model and only cares about things like treatment according to antipsychotics.

    It is also frustrating that this industry fueled by funding from pharmacuetical industry cannot determine the occurrence of spontaneous recovery and include it in their "scientific" literature. They take someone that has a brief psychotic reaction as being helped by medication and be deemed schizophrenic with a brain disease and no chance for recovery and a life on psychiatric drugs when they would have made progress and transcend the personality and improve functioning from resolving problems that resulted in psychosis.

    It is very vivid for me that efforts to perform alchemy on the mind and resolve problems from long term antipsychotic use results in resentments of the past family crisis for instance when I was developing my culturally accepted focus on leading a spiritually meaningful life with interest in opening my consciousness to new concepts my upbringing couldn't cope with and freeling trapped by the family for instance and how life is moulded and I am stigmatised. for some reason this leads to repressed emotional states of times of crisis with family when they called crisis teams to have me evaluated, and yeah I'm schizotypal in nature although my beliefs are culturally relivant.

    Like ppl talking about synchronicity I can relate to and the person talking about telepathy I can see that I tooo have done problem solving with the psychic phenomena and realized some phenomena is the work of deviant spirits who aren;t who they claim and have a limited outlook and reality in the material they present to a sensitive and leads to delusion if one takes the material too seriously or becomes obsessed with the phenomena. I believe in telepathy too as do sub-cultures who manage to deal with it without becoming disorganised, maybe since they are trained to deal with it and learn grounding techniques, not like it is some spontaeneous awakening that one isn;t ready for and finds disturbing. Clairvoyants develop their ability by using self-disciplin on the mind and finding empty space between thinking and projecting their mind onto the environment.



    plus the only reason interfering with dopamine seems to relate to psychotic positive symptoms is that they make the patient passive and unable to have an inner life which unfortunately can be quite rich and rewarding before antipsychotics take this away.....I think a lot of psychotics are misinterpreting their experience and are unable to cope with the unfolding of a new dimention in consciousness like third eye opening and crown chakra problems and yeah solar plexus and wanting to liberate their self and existence, personally speaking.....

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  13. Anonymous6:20 am

    Good reading, thank you. I wouldn't be so harsh towards psychiatry but my experience with it is minimal. A book I read once called the Bible, mentions the blind leading the blind and the inverse I suppose, seek and ye shall find. Maybe psychiatry just needs a base of provable data. Telepathy is a hard one to prove because you are usually trying to prove it to someone who is very biased against it. It's like trying to teach a bully to kiss like an angel. I ran the idea of telepathic prayer to a god by some older guys at a church once and they surprised me by being pleasant about it if noncommittal. Once I was relaxed around them the information started flying. I was so happy to finally prove to myself that it was real. I knew things about people I'd never met and multiplexed it into conversation comfortably on the fly. The voices are another matter. I've suspected brain matter similar to cancer turning from it's normal job during sleep building dreams to trying to form new personalities within me. Even considered highly evolved dinosaurs toying with humans like some rotten kid at the zoo. Or the rich bored, you name it. I guess it's been about 10 years now I've accepted that the voices are for the most part simply other people tired of having they're privacy invaded by panicky telepaths. IMHO sedatives for a good sleep routine and healthy eating are the cure. No pot, no tobacco, etc etc. We don't need them anyway. Naturally high is better. I don't recommend telepathic gatherings though. Seems like a good way to wreck or traffic jam, possibly even crippling. Dunno. Live and let live works for me.

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  14. Anonymous6:37 am

    I have a schizophrenic friend staying with me for along time.He used to be under treatment before but because of finanncial reasons i have to stop it.Now he is staying adopting freely without medication and doing well though sometimes it is very difficult to deal with because of his mood swing but im trying my best to help him and make him understand regarding his illness and providing him a healthy therapiutic environment.Now its his 5th year with out medication thanks God he always there to help me.

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  15. Anonymous4:48 pm

    My mom has schizophrenia and she has never been treated with medications. she doesn't understand she is sick and now she is worse. can anyone tell me what can I do for her? I've read all these posts but it looks like there's no hope.

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    1. Anonymous10:04 pm

      Hi, I am not sure if you have been able to find any support for yourself and your mom. I hope you have family and friends that are understanding and able to help you with your mom. In order to get her to admit she is sick; you will probably need to get the support of others. My mom also suffers from mental illness. When I was young; it hard to live with her sometimes and I often took on the role of mom. As an adult, I have a good relationship with her (we are more like friends) but, I know that she has to seek healing on her own and she has in many ways. She has become a Christian and is also going to college (she is working on her MFA). She has found freedom in her own identity and she is happy. Because I no longer feel completely responsible for her well being, I can focus on my own. For a child, mental illness can be over whelming; especially when a parent isn't well enough to parent. But, if you can grow to forgive your mom for that, you can have some peace and seek growth for yourself. Best wishes and prayers for you and your mom.

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  16. Anonymous11:26 pm

    I see definite commonalities here with my 24 year old son who was diagnosed with acute psychotic disorder,which progressed rapidly to schizophrenia. Ironically enough there is no history of this illness in the family, and as far as I know my son is the first..I have battled helplessly for six years now with a son on medication. I can honestly say if anything, I have only noticed further deterioration in his behavior and outlook, more than anything else. So WHAT is the answer? There are no rehabilitation centers that could help, the psychiatrists that I have consulted with, do indeed seem to be on a power trip with absolutely no definitive answer as to how to help or even propose effective treatment, absolutely no support or a hint as to how to get my son back to being just a tiny bit normal. As a mother I can assure you I would give anything to see delight,happiness,enthusiasm,spontaneity or even a hint of the 'young highly intelligent young man' he used to be. I watch helplessly and have no idea how to do anything other than care for him. His world consists of nothing more than breathing. No interests, no personality...I just see a mind filled with emptiness. We have tried all we can, but this horrific debilitating illness is nothing to be trifled with. I have no answers, and I am terrified of letting him go off of psychiatric medication for fear of losing what is left of him completely..

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  17. Anonymous9:19 pm

    my son is 28 and wont take meds he has a life and plays football twice a week listens to music has a few mates though is often distracted , though does ok with no meds lives on his own and can cook wash and buy new clothes when he wants,,,,

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  18. Would be really grateful if you guys can comment on this
    (http://shcizophrenia.blogspot.com/2013/09/my-experience-with-schizophrenia-below.html)

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  19. Anonymous12:03 am

    Life is too beautiful to take drugs anyway, however the mental health community are not noted for listening to this view and reality.

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  20. Anonymous12:12 pm

    some people who healed from schizophrenia without or with little medication have written autobiographies or others have written biographies about them. I know: Arnhild Lauveng, Dorothea Buck and John F. Nash. The books about and from them gave me hope to be medication-free one day.

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