People with schizophrenia not taking antipsychotics more likely to recover, states research

June 13, 2007
by Angela Hussain

People diagnosed with schizophrenia who are not on antipsychotics are more likely to experience recovery than those taking the medication, according to an American study.

Over 15 years, schizophrenia patients not on antipsychotics showed more periods of recovery than those taking antipsychotics, states a research paper in last month’s Journal of Nervous and Mental Disease.

Researchers reported that, after 10 years, 79% of patients on antipsychotics were psychotic, whereas 23% of those not on medication were psychotic. After 15 years, 65 per cent of patients on antipsychotics were psychotic, whereas only 28% of those not on medication were psychotic.

The study’s authors - Martin Harrow and Thomas Jobe of the department of psychiatry at the University of Illinois in Chicago – concluded that “not all schizophrenia patients need to use antipsychotic medications continuously throughout their lives.”

They stated that certain patient characteristics – such as a “favorable personality” – helped those not on medication to experience recovery.

The study was on 145 patients - 64 diagnosed with schizophrenia, and a control of 81 patients who had another psychotic diagnosis, such as paranoid disorder.

The research was part-funded by America’s National Institute of Mental Health.

Read for yourself:
Abstract of "Factors Involved in Outcome and Recovery in Schizophrenia Patients Not on Antipsychotic Medications: A 15-Year Multifollow-Up Study; Journal of Nervous and Mental Disease"

Paper in full (external link):

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Off medication - and more in control

Comment by: Reshma Val, student, Pune City, India
Date: June 20, 2007:

I am a patient of schizophrenia and have stopped medication since 1st December 2006. I am in better control of my symptoms right now. I have no negative symptoms, though my positive symptoms have always been around, I use them to inspire me. I'd like to know more about what is a "favourable" personality.

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We need larger studies

Comment by: Louise Pembroke, mental health activist, London
Date: June 20, 2007

This is good news for the hearing voices movement - and what many of us already knew. We now need larger scale studies so that the evidence base can't be dismissed.

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No control for severity of condition

Comment by: Liam Mason, research assistant, University of Manchester
Date: June 26, 2007

The study doesn't control for severity of condition. Therefore, patients not on antipsychotic medication may be drug-free because their symptoms are not as acute as those who are on antipsychotics.

The difference therefore could just reflect differences in recovery rate between acute/chronic and moderately unwell patients.

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Don't assume

Comment by: Louise Pembroke, mental health activist, London
Date: June 28, 2007

I can't agree Liam. Marius Romme and Sondra Escher's research showed that the experience of hearing voices was similar across all diagnostic groups and between patients and non-patients. It wasn't the case that those labeled as schizophrenic had worse experiences than those viewed as depressed or those with no contact with services. The main difference was in anxiety, ability to cope, responses from others and social networks. I don't think it follows that people with severe debilitation are less likely to recover than those will lesser experiences. Then how do we rate level of disability given that those most disabled are often as a result of the treatment and not their condition? You can't assume that those who have fought to remain off drugs experience less distress.

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A favourable environment helps

Comment by: Omotayo Onabamiro, unemployed mechanical engineer, Ibadan, Nigeria.
Date: June 28, 2007

This is good news. Psychiatrists here in Nigeria only seem to think antipsychotic drugs are the main defence against schizophrenia.

I was diagnosed with schizophrenia in 1984 and though I take my drugs now, there were certain times I went off the drugs. Usually when I went off the drugs I relapsed but there were
time when I went off the drugs but did not relapse. These were times I was in a "favourable environment" such as living with friends in an amicable way in a hostel.

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Irresponsible and offensive reporting

Comment by: Marcus Manly, Texas, USA
Date: July 12, 2007

I am offended by the title of Angela Hussain's article. The research did not state a greater likelihood of recovery for all patients who dropped their medication. Irresponsible reporting like this causes more pain than medications do. You are dancing on the edge of a serious illness. My nephew has a mental illness, and try reasoning with a guy who is dismantling his car because he believes his air conditioning vents are spraying viruses on him, and sets his car on fire to "get rid of the rats".

If you are off medication, that's great. But tell the whole story, and include who helped you and how. I'm sorry if I offend, but the medical profession is the best shot for most people - because they know a lot more about these illnesses than you do. Most of these comments only serve to encourage people to leave medical care, and the results can be devastating.

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Does not depend on being acute/chronic

Comment from: Reshma Val, student, Pune, India
Date: July 25, 2007

Liam, I do not think it really depends on the acute/chronic state. In my case, during my treatment I still had positive symptoms but they were only under the control of the meds.
Now, without my meds, I am in control of those same symptoms and I have no negative symptoms at all. I am very much symptomatic, but not many can notice that unless they know me.

This article holds true for many. At the same time it shouldn't make others who need medications stop theirs.

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