hippopotamus Posted February 4, 2013 Share Posted February 4, 2013 Alto asked me to start a topic about controversies regarding schizophrenia, so here goes. I dont have the time and energy to dive deeply into it, but I can point to information that people can then use to look closer into the matter. Here's something to get started. I'm planning to add more info later on. Schizophrenia and 'schizophreniform' disorders are lifelong, chronic and progressive disorders[/u] Although this still is a widely accepted view in most regular psychiatric services, it doesnt reflect the actual state of affairs. See for example the following articles: http://schizophreniabulletin.oxfordjournals.org/content/early/2012/12/04/schbul.sbs135.full http://bjp.rcpsych.org/content/178/6/506.long The gist of these articles is that schizophrenia is a heterogenuous disorder, meaning that people who share the same diagnosis all have different constellations of problems and symptoms. The outcome of schizophrenia is heterogenuous as well: There appears to be a group that is able to recover completely, a group that is able to recover to a significant degree and a group that experiences a bad long-term outcome. As the first article shows, the still widely-presumed progressive nature of schizophrenia is a myth. According to this article, people with schizophrenia as a whole dont tend to deteriorate and there is no evidence for the theory that schizophrenia is a neurodegenerative disease like Alzheimers or Parkinson. See for info against the supposed 'neurotoxicity of psychosis' also for example http://www.ncbi.nlm.nih.gov/pubmed/16254059?dopt=Abstract Schizophrenia as a genetically determined biochemical disease Although there appears to be a genetic contribution to vulnerabilty for developing schizophrenia, according to this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632485/, 'the recent Gene × Environment findings in psychiatry suggest that genes are likely to influence disorder mostly indirectly, via their impact upon physiological pathways, and work by increasing (or decreasing) the likelihood of developing a psychiatric disorder, rather than as direct causes of disorder per se. Thus, the notion of “a gene for …” is misleading and diverts attention from more important issues' it is also clear that there are many environmental factors that probably contribute to the chance pf developing schizophrenia, like malnutrition of mothers during pregnancy, use of cannabis, a history of childhood trauma (http://www.ncbi.nlm.nih.gov/pubmed/22901835 ), living in a rural environment and having a low IQ. 'People with schizophrenia need to be on the drugs for the rest of their lives' This is a myth that has been heavily sponsored by the pharmaceutical industry. First of all, the drugs are frequently ineffective or only partly effective. See for example this article that claims that up to 60 % of treated people still have psychotic and cognitive complaints despite active pharmacotherapy: http://www.psychiatrictimes.com/schizophrenia/content/article/10168/1433177?pageNumber=4. Also, according to the article ' Full Disclosure: Toward a Participatory and Risk Limiting Approach to Neuroleptic Drugs' by Volkmar Aderhold and Peter Stastny, which can be retrieved via the website of psychrights.org (somehow I couldnt find it in Pubmed): ' at least 20% of all individuals first diagnosed with "schizophrenia" never experience a relapse in their lifetime. 5 - 10 % of people with schizophrenia dont seem to experience any positive effect of neuroleptics. 20-30 % of people only experience a temporary and partial reduction of mainly positive symptoms. About 40 % of people with schizophrenia experiences a relapse within one year after hospital discharge despite taking the medications and about 20 % of people with schizophrenia experience a relapse within one year even though theyre on long-acting depot medications. ' Second of all, this myth is based on research and meta-analyses that indeed show that people who are maintained on neuroleptics experience less relapses than people who go off the drugs. However, this research is flawed in a number of ways. First of all, it doesnt take into account the fact that research and publications that are funded by the pharmaceutical industry (which is the majority of the research into medicine) are systematically manipulated and biased to make the medicines look more effective then they actually are. See for example: http://www.ncbi.nlm.nih.gov/pubmed/12775614 , http://www.ncbi.nlm.nih.gov/pubmed/18754841 , http://www.ncbi.nlm.nih.gov/pubmed/20490338 Second of all, it doesnt take into account the fact that relapses when going off of medication, dont have to be caused by the supposedly underlying chronic condition, but can instead be caused by withdrawal-effects: When going off of antipsychotics too quickly, people are vulnerable to experiencing supersensitivity psychoses. This is a DRUG-induced psychosis. This mechanism seems to be widely unacknowledged in mainstream psychiatry. Furthermore this mechanism is possibly partly responsible for a wide range of research-results that show that going off of antipsychotics leads to a high rate of relapses. See: Joanna Moncrieff *, which can also be found through psychrights.org http://psychrights.o...dhypdrugred.pdf Another factor that can be an important contributor to people experiencing relapses when they go off or taper off their drugs, is the fact that they're continuously told by the people around them that they really need their drugs. This increases anxiety and stress, which in turn increases the chance for relapses. See the very important article of Joanna Moncrieff on this subject, ' Why is it so difﬁcult to stop psychiatric drug treatment? It may be nothing to do with the original problem Joanna Moncrieff *, which can also be found through psychrights.org http://psychrights.org/Articles/Moncrieffe2006medhypdrugred.pdf Also, something that is generally overlooked when intepretating placebo-controlled drug trials, is the fact that, when treating people with obvious and serious mental and emotional problems, a placebo-control condition probably isnt a very honest control condition. It might be a way to see if the drugs are more effective than placebo's, but it doesnt say anything about the way these people would function without drugs when they instead had been offered adequate non-drug therapies. Again, this is laid out in the earlier cited article ' ' Full Disclosure: Toward a Participatory and Risk Limiting Approach to Neuroleptic Drugs' by Volkmar Aderhold and Peter Stastny' Have been on Seroquel XR from 2008. Dosages have fluctuated quite a bit. Rough guess: I've been on 250-300-350-400-450-500 mg from 2009-summer 2012. Started tapering july 2012 with cuts of 50 mg. By then I had been on 450 mg for a while. October 2012: 200 mg. Due to flu-like WD reinstated to 250 mg nov 12th. Link to comment Share on other sites More sharing options...
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