Mental health counselor Ron Unger submitted a guest commentary to The Register-Guard as part of an ongoing debate about the role of neuroleptic psychiatric drugs, also known as neuroleptics. Here are resources and references for readers interested in Ron’s commentary.
Resources of interest to readers of Ron Unger’s guest commentary
One of the most important pieces of information for many who reference this page may be information about alternative approaches that have been shown to work. Some of these approaches, such as the highly successful Open Dialogue approach, are not yet available in most parts of the United States. Other approaches, such as psychotherapy with a competent person, may be available if you succeed in finding the right person. You can read about a variety of such alternatives at:
http://psychrights.org/Research/Digest/Effective/effective.htm
One of the other most important kinds of information may be how people safely get off medications once they are on them. Each case is individual, but some possibly helpful ideas about getting off medications have been posted to the web. An organization in the UK called “Mind” has a webpage that addresses this subject in some detail, click here.
A good guide to bringing up issues about medication with ones prescriber is available here . Another helpful website, produced by a psychologist who was told as a young man that he would “always have to take medications for schizophrenia” is at http://comingoff.com/
For a longer pamphlet containing detail on the rationale for empowerment concerning medications, and many other important considerations, click here.
Finally, a guide for therapists who wish to help their clients consider reductions or elimination of medications is available at
http://recoveryfromschizophrenia.org/blog/?page_id=31
Sources of information for Ron Unger’s guest viewpoint column:
John Bola’s article in the Schizophrenia Bulletin, which shows that long term studies do not show antipsychotics to be effective, is available at:
http://socialwork.usc.edu/~bola/publications/Bola2006.pdf
Information about the two World Health Organization studies that showed better outcomes in developing countries with much less access to medications is available at
http://psychrights.org/Research/Digest/Chronicity/who1.pdf
and at
http://psychrights.org/Research/Digest/Chronicity/who2.pdf
A comparison of treatment outcomes in the pre-antipsychotic era with outcomes once antipsychotics were in standard use can be found at:
http://psychrights.org/Research/Digest/Chronicity/comparison2x5.pdf
Courtenay Harding PhD did one of the most important long term outcome studies for “schizophrenia” and is very knowledgeable about the other such studies. In a paper available at:
http://psychrights.org/Research/Digest/Chronicity/myths.pdf
Dr. Harding writes that “When analyzing the results from the long term studies, it was clear that a surprising number (at least 25% -50%), were completely off their medications, suffered no further signs and symptoms of schizophrenia, and were functioning well.”
Also, in The Vermont Longitudinal Study of Persons With Severe Mental Illness, II: Long-Term Outcomes of Subjects Who Retrospectively Met DSM-III Criteria for Schizophrenia, by Courtenay M. Harding, Ph.D., George W. Brooks, M.D., Takamaru Ashikaga, Ph.D., John S. Strauss, M.D., and Alan Breier, M.D., American Journal of Psychiatry 144:6, June 1987, 727 at p. 730,it was reported that 68% of people diagnosed with schizophrenia had recovered and of these 50% never took psychiatric medications and another 25% only took them periodically when they felt they needed them to control symptoms.
See, also Vermont 1, by Courtenay M. Harding, Ph.D., George W. Brooks, M.D., Takamaru Ashikaga, Ph.D., John S. Strauss, M.D., and Alan Breier, M.D., American Journal of Psychiatry 144:6, June 1987, 718
The long term outcome study that Areford referred to, where recovery rates were 8 times higher among those off medications (or 5% for those on medications, 40% for those off medications) is available at:
http://psychrights.org/Research/Digest/NLPs/OutcomeFactors.pdf
Note that the authors attempted to suggest that people who got off medication and then recovered did so only because they happened to be those who had more strengths to start out with, but they ignored the alternative hypothesis that it was these greater strengths that allowed them to get off the medications which then resulted in them having stronger recoveries. At any rate, this study contradicts the notion that everyone diagnosed with schizophrenia has to stay on antipsychotic medications.
The National Association of State Mental Health Program Directors Medical Directors Council report on the 25 year earlier than average death rates can be found in a paper is available, click here.
or a powerpoint presentation is available, click here.
One paper addressing the changes in mortality rates induced by the atypical antipsychotics can be found at A Systematic Review of Mortality in Schizophrenia at:
http://psychrights.org/Articles/SystematicreviewofSchizophreniamortality.pdf
About suicide and antipsychotics: See the study Lifetime suicide rates in treated schizophrenia: 1875-1924 and 1994-1998 cohorts compared, by D. Healy, M. Harris, R. Tranter, P. Gutting, R. Austin, G. Jones-Edwards, and A.P. Roberts, British Journal of Psychiatry, (2006), 188 , 223 -228. This study found a 20 fold increase in the suicide rate for people diagnosed with schizophrenia since the introduction of the antipsychotics. The study indicated this was probably a result of both deinstitutionalization and the antipsychotics.
An article that includes a good summary of the evidence on brain damage, and reasons for concern, is available at http://psychrights.org/Research/Digest/NLPs/EHPPAderholdandStastnyonNeuroleptics.pdf
Another slightly older article of interest is at
http://psychrights.org/Research/Digest/NLPs/NeurolepticNeuropathologyPHarrison.pdf
If you want an even broader access to information about brain damage, you can look through all the articles available at
http://psychrights.org/Research/Digest/NLPs/neuroleptics.htm
The figure about slower withdrawal being three times more successful was cited in the book Staying Well After Psychosis and referenced a meta-analysis called “Neuroleptic withdrawal in schizophrenic patients. A review of the literature” that was published in Arch Gen Psychiatry. 1995 Mar;52(3):173-88.
One of Staggenborg’s assertions was that “untreated recurrent psychosis” is known to correlate with deterioration over time. This assertion is frequently used to frighten people away from trying to discontinue medications or to address problems without medications. The truth is probably much more complex, and it is known that many people endured a number of recurrences when attempting to get off medications, before finally doing it for good and then going on to have successful lives.
Some articles questioning the assumption of “deterioration” can be found at http://psychrights.org/Research/Digest/NLPs/neuroleptics.htm#Failure
One example of a usually non-drug early intervention program is the Finnish Open Dialogue approach, which has been shown to reduce “schizophrenia” by helping people resolve their psychosis before it lasts long enough to earn a “schizophrenia” diagnosis. In one area using this approach, incidents of new cases of “schizophrenia” were reduced from a rate of 33 per year in 1985 to just 2 cases in the first two years of the 2000’s. See:
http://psychrights.org/Research/Digest/Effective/fiveyarocpsychotherapyresearch.pdf
Another example of a non-drug intervention program is cognitive therapy, which has been used with people who are just starting to experience some psychotic symptoms, and has been shown to often prevent any further problems with psychosis. See
http://psychrights.org/Research/Digest/Effective/Cognitivetherapyforpreventionofpsychosis.pdf
More information on recovery in general is located at:
People in Lane County who want to network with others interested in organizing for alternatives can contact MindFreedom at lane@mindfreedom.org or 541-345-9106.
A web folder about MindFreedom Lane County can be found here:
https://mindfreedom.org/as/act/us/or/lane
You can also network with other concerned people at meetings of the Opal Network, contact LILA for more information at 541-607-7020. Another option for consumers is to attend Lane County Consumer Council meetings, 4th Tuesday of the month at Lane County Mental Health, 1:30 PM, contact Safe at 762-4900 (Joyce is a good person to talk to.) For more info on Opal Network: