Going against decades of conventional wisdom, new, robust research from the National Institute of Mental Health suggests that schizophrenia shouldn’t just be treated with antipsychotic drugs. Instead, a multidisciplinary approach that includes both psychotherapy and family support, combined with lower doses of antipsychotic medications, appears to work much better than drugs alone.
This new research should act as a wake-up call to all mental health professionals, people with schizophrenia, and their families.
The new study, begun in 2009, examined 404 people who had a first episode of psychosis, which is usually the first significant sign of schizophrenia. Half got the usual treatment approach (focused on high dose antipsychotic medications), while the other half of the group got a new, combined approach that offered low dose (about half the regular dose) of antipsychotics, along with one-on-one psychotherapy and education for the family of the person with the symptoms, to help them better understand the disorder and how they can best help.
At the end of the two-year study, people in the group who received the combination treatment had greater relief from their symptoms and were functioning better overall than those who just received the standard treatment.
The specialists offered recovery-oriented psychotherapy, low doses of antipsychotic medications, family education and support, case management, and work or education support, depending on the individual’s needs and preferences.
The treatment approach was based on shared decision making between the client and team. In addition, the treatment involved family members as much as possible.
“The goal is to link someone experiencing first episode psychosis with a coordinated specialty care team as soon as possible after psychotic symptoms begin,” said Kane.
Benedict Carey, reporting for The New York Times, agreed saying:
Experts said the findings could help set a new standard of care in an area of medicine that many consider woefully inadequate: the management of so-called first episode psychosis, that first break with reality in which patients (usually people in their late teens or early 20s) become afraid and deeply suspicious. The sooner people started the combined treatment after that first episode, the better they did, the study found. The average time between the first episode and receiving medical care — for those who do get it — is currently about a year and half.
The Times also noted that this new approach is actually an old approach, used for years in European countries:
The more holistic approach that the study tested is based in part on programs in Australia, Scandinavia and elsewhere that have improved patients’ lives in those countries for decades. This study is the first test of the approach in this country — in the “real world” as researchers described it, meaning delivered through the existing infrastructure, by community mental health centers.
Here’s to hoping that mental health professionals take heed of the new study and start prescribing more than high-dose antipsychotics to help people with schizophrenia.
For further information
The New York Times: New Approach Advised to Treat Schizophrenia