Posted by med_empowered on September 24, 2005, at 19:46:51
In reply to Re: New and old antipsychotics have similar efficacy » ed_uk, posted by alexandra_k on September 24, 2005, at 15:26:37
I've had kind of mixed reactions to this study. On the one hand, having taken most of the atypicals, I found it hard to imagine that these were *wonder drugs*; I found it even harder to imagine that all the old drugs could have been *that much* worse. And I'm glad to see that, finally, after billions of $$$ have been spent and shrinks have been going on and on about schizophrenia becoming "a manageable illness," blah blah blah (with no hard statistical backing, mind you) someone has finally taken the time to do a more or less objective comparison to see what was really going. The bad news is...the medications we have now are about as effective as what we had in the 50s; Trilafon (perphenazine), the old drug used as a comparison agent in this study, has been around since 1958. (Interestingly, its part of the ORIGINAL antipsychotic/antidepressant combo: Triavil, which is perphenazine+elavil). I think maybe its time to focus more on therapy and psychosocial interventions, and lay off the meds so much. This study makes clear what lots of people have suspected for a long time: despite all the hooplah, the neuroleptics really aren't that great. For alexandra..you might want to look up the Soteria project, which ended in the 70s, I think...the data's really good though (loren mosher, the soteria guy, was once head of the NIMH, and the study design was *excellent*, especially for a psychiatric study). From what I understand, some people, including the author of "Mad in America" are trying to set up a new Soteria House somewhere in Alaska...since its drug-free and they use mostly non-professional support staff, they've been facing a bit of a battle in getting everything OK'd (also, drug companies have WAY more power and influence now than in the 70s, so they stand to lose a lot if this project produces good, cost-effective results). As much as I dislike the neuroleptics, I don't think medications *can't* play a role in treating schizophrenia; I just don't think any of the "antipsychotic" meds we have right now are really going to help that many people. Some studies in the past indicated that high-dose benzos helped calm people down, reduced depression, and allowed them to function. There's also some evidence that certain stimulants (like Provigil) could improve cognition in those with schizophrenia or other disorders. I think medication will only help when psychiatry moves from a domineering, kind of fascist framework of "controlling symptoms" and "reducing behavioral disturbances" towards "empowering people" and "improving quality of life". I mean, lets face it: neuroleptics and antidepressants were both introduced in the 50s. Since then...the suicide rate has risen, violence has become more common, and both schizophrenia and depression remain largely as disabling as ever, despite widespread medication-based "therapy". I think if medical treatment of emotional issues is going to be useful for anything besides selling pills, its going to have to take on a more humane, patient-centered perspective; otherwise, at some point, people (and their governments and insurance providers) are going to get sick and tired of paying out $$$ for pills that don't seem to be doing very much for improving life. Just my opinion.
poster:med_empowered
thread:558590
URL: http://www.dr-bob.org/babble/20050921/msgs/559165.html