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Important new research on schizophrenia treatment


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Not sure about the rules on posting whole articles here (read over rules carefullly), but as you can't read this without a subscription I thought I'd have a go.

Basically, the idea is the modern catechism about sz meds maybe if not wrong, at least overstated. Yeah...actually, wrong, come to think of it.

Said catechism being that under all circumstances antipsychotic meds are not merely preferable in treatment of persons with sz,but indispensible. This has reached the point (my son's shrink is one proponent) where even the merely "at risk" for develping the disorder, are recommended to receive meds as prophylaxis. Understand this means that or them as for the full-blown, that this is to involve indefinite treatment and despite the fact (exact percent varies by study and definition of "at risk") that something like 40+ % would never go on to be diagnosed as such!

(Also understood are the many dangerous and poorly understood side effects. The meds out there now, at a primitive stage, are all so far as I know based in some way on the unproven "Dopamine Hypothesis" linking dopamine transmission to the disorder. Therefore, so it follows, a dopamine blockade _ affecting the whole brain - is ALWAYS in the patient's best interest especially because sz is currently believed to actually be "neurotoxic" - to kil brain cells.)

Understand, that what is being challenged (on the basis of an extensive longitudinal study) is not that the risk/benefit analysis does not favor medicating most patients, but merely that there are some who all things considered, fare as well or better without antipsychotics.

Naturally, this is being challenged in high circles - and by the doubtless well-intended for the most part (not for example, by those representing Big Pharma) . Their reason as with objections to most controversial research, seems to be less content riented as it is for fear of the consequences of its being implemented incautiously beyond it's scope.

However this is NOT what they say. You be the judge.

Note interestingly, the authors also propose the existence of degrees and levels of the disorder rather than the "no such thing as a little bit pregnant" approach adopted to date.

****

http://www.nytimes.com/2006/03/21/health/p...agewanted=print

(edited to remove article text because I can't afford a lawyer --VE)

http://power2u.org/articles/recovery/revisiting_schizophrenia.html

Just found a link that's accessible without a subscription:

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Hi RL,

As the daughter of an untreated mildly schizophrenic mother I have to say I agree with the spectrum theory. My mom has had times of greater psychosis and times when she can pull it all together and deal just fine. She's never been able to work, but she finds things to do that interest her. And my dad goes with the flow (although at times I think he's got his head in the sand...).

Of course, my mom's illness hasn't left me untouched. And she has co-morbid OCD of the hoarding variety...so I spent alot of time as a kid hating all of her behaviors.

I guess one of the saving graces about my mom is that she's not mean when she is psychotic. Sometimes ragey, but she's never had delusions that I am trying to do her harm. After reading other stories of children of sz people, I feel really fortunate...and that's a complete 180 in my thinking.

I hope your son finds a good spot and that you are able to have a reasonable relationship. I know how hard dealing with this illness is for family members. It's disorienting for a child, but must be so much more difficult for a parent...or at least difficult in a very different manner.

--Weasel

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Realitytest,

generally we shy away from posting whole articles.  the summary you gave is great, and quotations with a source are fine.  but the NYT and other sources require membership because they want people to pay for their material, and that's their right under copyright law.  so, if you could remove the full text of the article, and just leave the link and your summary, and maybe even shorter quote from the article, that would be great.

thanks!

Penny

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Guest Guest_realitytest_*

Realitytest,

generally we shy away from posting whole articles.  the summary you gave is great, and quotations with a source are fine.  but the NYT and other sources require membership because they want people to pay for their material, and that's their right under copyright law.  so, if you could remove the full text of the article, and just leave the link and your summary, and maybe even shorter quote from the article, that would be great.

thanks!

Penny

<{POST_SNAPBACK}>

Thanks, Penny.  Wasn't sure about the article.  The controversy, comments and nature of the reserach itself, I felt was important, which is why I posted it.  As far as the membership goes, it is actually free.  In fact,  it isn't really membership, it's registration.  Don't know why everyone doesn't register on this account, considering what great coverage they have (including  links)  on everything. Of course, as with everything online,  I use a fake name as special Yahoo email.

What they are charging for now are editorials, and accessing archives . That is, after a week, most articles ARE only available to their paid members (a relatively new deal called "Premium" something. ).  However, even then for articles they feel are a public service, they often are permanetnly available.

If you aren't following the research and dogma  on sz , this is a major, major breakthrough.  In fact,  a busy neurologist I saw that same day said yes, he had not only heard of the articlee,  but that it was already being talked about a good bit! 

The article itself will appear in Schizophrenia Review in their next month's addition (I tried to find and link that here instead of posting the whole thing from the NYTimes .  THe scrolling alone is daunting to many! )  Would it be OK with you, if I leave this up until those whom it most concerns have a chance to look at over and download it if desired?  Then I could leave only the NYTimes link, and an offer to send the original to any? (As if I  follow through on anything lately - finger "gun" to head emoticon. :embarassed: ).  Or hopefully,  I could substitute that working link to Sz Rev.

I do not think the NYTimes minds downloading whole article or partial articles,  as long as they and the author are credited - especially when they are medical. 

Nice to meetcha!

rt

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RT,

internets and posting of things and etc. is confusing.  and it's sometimes annoying when you refrence a link and then in a month the link goes dead. i doubt the NYT is going to come sue us, but blah.

i find the new paying for editorials thing annoying.  i highly doubt that the decision to do that was actually based on the desires of the writers of the editorials, but that's the reasoning i've heard for it. at least the articles are still free. 

i was reading that new scientific american mind magazine in the airport the other day and there was this article (sadly the part i'm talking about is requires paying them to read it, heh)  along the lines of "omg schizophrenic patients do not like their medications" and it just fucking blew my mind.  this is news?  do doctors even talk to patients, or do they just talk to thier asses in the mirror?  yes, newsflash: antipsychotics are not pleasant to be on.  uh.  um.  yeah, the whole medication compliance issue is because they are so much fun that people like to go on and off them becuase tapering is a blast!!

it's good to hear that some doctors are apparently paying attention to patients and that there is hope that the treatment of schizophrenia will become less dogmatic. 

i didn't realize that they pre medicate people at high risk for schizophrenia before they develop positive symptoms.  that seems odd to me.  we don't know enough yet about what causes mental illness to make that type of decision, in my opinion.  i know i've inherited some of my mother's issues, but i'm happy i'm not medicated based upon her issues... i find that idea disturbing.

penny

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I certainly understand VE's cautious atttude!.. Let me sugggest for now therefore (applies in general) that anyone interested in this or other articles just register for the  NYtimes.  Then you can access all their articles - at least during the first week after they appear if not longer (they are archived, most of them,  after one week - means only a coupla hundred word summary remains).

Since this article appeared on the 21st,  you have at least three more days to read the original on line at NYTmes. com.  Registration takes under  five minutes, especially if you already have a phoney email name set up (only needed if  you don't want to give your real name and/or regular email).  Note YOU CAN BLOCK POPUP ADS (they can be annoying). 

rt

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Here's a good link to Schizophrenia.com about the NYTimes article and reseatch reviewed.  This one won't go out of date.

http://www.schizophrenia.com/sznews/archives/003190.html

An excerpt:

As it suggests in the article, studies indicate that somewhere between 10 percent and 40 percent of people with symptoms of psychosis may be able to manage without medication. But there is no test to identify these people, and "psychiatrists say that withholding drugs after a full-blown psychotic episode is highly risky. Psychotic episodes tend to become worse over time when untreated, they say, and the effect of the experience on the brain is still unknown."

Following is an excerpt of the NY Times Article:

... But a report appearing next month in one of the field's premier journals suggests that when some people first develop psychosis they can function without medication

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