Posted by novelagent on May 23, 2012, at 16:35:30
In reply to Re: link for study » zazenducke, posted by SLS on May 21, 2012, at 14:41:08
I believe until very recently, it was standard to, after the first episode, prescribe an antipsychotic and then "re-assess" after a certain period. My doc at the hospital said this would happen six months in. That was a year and a half ago.
At the clinic where I see my doc, I asked about this, and was told the new trend is to wait a year, according to one counselor. My doc said the same thing, citing the Finish study. But my present resident doc I now see says it's 2 years, and the nurse who gives me my monthly Invega Sustenna injection, she's a PhD N.P., and she balked when I asked about this and gave me a hard time just for bringing it up. She said mental illness doesm't go away (not true, remission does happen, but I think she means it's just more dismally unlikely for schz).
Anyhow, the fact is that the more someone is off their meds for the first couple of years at least, the more this illness gets its grips into the brain, and the ditch is dug. I had nothing more than a 24 hour episode, I checked myself into the hospital the same day, and was treated with an atypical a couple of days later (the episode lasted until three days into Zyprexa).
So my prospects for enterting complete and total remission are pretty good-- I've been on depot medication ever since I was in the hospital a year and a half ago. I figure I'll give myself another few yesrs, and maybe test things out maybe 5 years out of the illness?
The problem is, there's brain damage that goes on during the psychosis, so that's the only downside of testing things out. Of course, I plan on doing it with some Invega pills by my side. and the moment I might hesr voices, I'm taking them. I don't mess around. Or I could wait until I'm closer to being a geriatric....
What interests me is how remission did occur in insane asylums prior to antipsychotics. "The Mind That Healed Itself" is a book written by someome who was a patient who recovered from mental illness, although I haven't read it.... it was written in 1912.
> > http://www.ncbi.nlm.nih.gov/pubmed/22340278
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> What I see is a study that fails to report the severity of the index episode of schizophrenia for each patient that they followed. It is possible that the people who did well without taking antipsychotics were not that ill to begin with. These people had the insight to "self-select" themselves to discontinue their treatment. Of course, maybe the medication ACCOMPLISHED THE MISSION: achieve full remission without the need for further treatment.
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> I often have difficulty deciphering what the authors had in mind when they chose the words to compress the entirety of their paper into a brief abstract. I'm sure the experts have no trouble, though. They probably speak the same language. Perhaps the severity of the index episodes is taken into account in their statistics appearing in the full text.
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> I imagine that antipsychotics work well enough for some people such that they achieve a stable remission that allows for the discontinuation of these medications. This is true of antidepressants. I am guessing that case history is taken into consideration when making treatment decisions.
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> I have known a dozen or two people with various presentations of schizophrenia who were very thankful that they were treated with antipsychotics. I don't think this is a black or white issue, though. People come in all colors. For me, seeing is believing.
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> - Scott
poster:novelagent
thread:1018380
URL: http://www.dr-bob.org/babble/20120522/msgs/1018562.html