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Post by Admin on Feb 22, 2021 11:56:51 GMT
Recovery Rate Six Times Higher For Those Who Stop Antipsychotics Within Two YearsNew research finds that people with "serious mental illness" who stop taking antipsychotics after initial treatment are more likely to recover, even accounting for baseline severity. www.madinamerica.com/2021/02/stop-taking-antipsychotics-six-times-likely-recover-serious-mental-illness/A new study by Martin Harrow, Thomas Jobe, and Liping Tong found that odds of recovery from “serious mental illness” were six times greater if the patient discontinued antipsychotics within two years. The study followed patients with schizophrenia and affective psychosis (bipolar and depression with psychotic features) diagnoses for 20 years. The study was published in Psychological Medicine. Specifically, the researchers found that those who stopped taking antipsychotic medication within two years of first taking the drug were almost six times (5.989) more likely to recover from “serious mental illness” and were only 13.4% as likely to be re-hospitalized. “Regardless of diagnosis, after the second year, the absence of antipsychotics predicted a higher probability of recovery and lower probability of rehospitalization at subsequent follow-ups after adjusting for confounders,” the researchers write. Psychol Med . 2021 Feb 8;1-11. doi: 10.1017/S0033291720004778. Online ahead of print. Twenty-year effects of antipsychotics in schizophrenia and affective psychotic disordersMartin Harrow 1, Thomas H Jobe 1, Liping Tong 2 Affiliations expand PMID: 33550993 DOI: 10.1017/S0033291720004778 pubmed.ncbi.nlm.nih.gov/33550993/Abstract Background: Studies that examine course and outcome in psychosis have reported considerable heterogeneity in terms of recovery, remission, employment, symptom presentation, social outcomes, and antipsychotic medication effects. Even with demonstrated heterogeneity in course and outcome, prophylactic antipsychotic maintenance therapy remains the prominent practice, particularly in participants with schizophrenia. Lack of efficacy in maintenance antipsychotic treatment and concerns over health detriments gives cause to re-examine guidelines. Methods: This study was conducted as part of the Chicago follow-up study designed as a naturalistic prospective longitudinal research study to investigate the course, outcome, symptomatology, and effects of antipsychotic medication on recovery and rehospitalization in participants with serious mental illness disorders. A total of 139 participants with 734 observations were included in the analysis. GEE logistic models were applied to adjust for confounding factors measured at index hospitalization and follow-ups. Results: Our data show that the majority of participants with schizophrenia or affective psychosis experience future episodes of psychosis at some point during the 20-year follow-up. There was a significant diagnostic difference between groups showing an increase in the number of future episodes of psychosis in participants with schizophrenia. Participants with schizophrenia not on antipsychotics after the first 2 years have better outcomes than participants prescribed antipsychotics. The adjusted odds ratio of not on antipsychotic medication was 5.989 (95% CI 3.588-9.993) for recovery and 0.134 (95% CI 0.070-0.259) for rehospitalization. That is, regardless of diagnosis, after the second year, the absence of antipsychotics predicted a higher probability of recovery and lower probability of rehospitalization at subsequent follow-ups after adjusting for confounders. Conclusion: This study reports multiple findings that bring into question the use of continuous antipsychotic medications, regardless of diagnosis. Even when the confound by indication for prescribing antipsychotic medication is controlled for, participants with schizophrenia and affective psychosis do better than their medicated cohorts, strongly confirming the importance of exposing the role of aiDSP and antipsychotic drug resistance. Keywords: Schizophreni; affective psychosis; antipsychotic medication; dopamine supersensitivity psychosis; longitudinal study.
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Post by Admin on Feb 27, 2021 17:18:26 GMT
Psychopharmacological ApproachIn ISPS there is a hot debate about the pro and cons of medication. On this page you find links to information how medication works, what is the best treatment strategy and what can be alternatives. Some people with experience with psychosis choose to use medication in a dose as small as possible, some can manage without. It is different for every person. If you want to stop with medication read the harm reduction guide! www.isps.org/index.php/learning-resources/learning-resources/specific-methods-of-therapy/item/450-psychopharmacological-approach-and-neurobiologywww.willhall.net/files/ComingOffPsychDrugsHarmReductGuide2Edonline.pdfTo continue or not to continue? Antipsychotic medication maintenance versus dose-reduction/discontinuation in first episode psychosis: HAMLETT, a pragmatic multicenter single-blind randomized controlled trialMarieke J. H. Begemann, Ilse A. Thompson, […]Iris E. C. Sommer Trials volume 21, Article number: 147 (2020) trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3822-5Abstract Background Antipsychotic medication is effective for symptomatic treatment in schizophrenia-spectrum disorders. After symptom remission, continuation of antipsychotic treatment is associated with lower relapse rates and lower symptom severity compared to dose reduction/discontinuation. Therefore, most guidelines recommend continuation of treatment with antipsychotic medication for at least 1 year. Recently, however, these guidelines have been questioned as one study has shown that more patients achieved long-term functional remission in an early discontinuation condition—a finding that was not replicated in another recently published long-term study. Methods/design The HAMLETT (Handling Antipsychotic Medication Long-term Evaluation of Targeted Treatment) study is a multicenter pragmatic single-blind randomized controlled trial in two parallel conditions (1:1) investigating the effects of continuation versus dose-reduction/discontinuation of antipsychotic medication after remission of a first episode of psychosis (FEP) on personal and social functioning, psychotic symptom severity, and health-related quality of life. In total 512 participants will be included, aged between 16 and 60 years, in symptomatic remission from a FEP for 3–6 months, and for whom psychosis was not associated with severe or life-threatening self-harm or violence. Recruitment will take place at 24 Dutch sites. Patients are randomized (1:1) to: continuation of antipsychotic medication until at least 1 year after remission (original dose allowing a maximum reduction of 25%, or another antipsychotic drug in similar dose range); or gradual dose reduction till eventual discontinuation of antipsychotics according to a tapering schedule. If signs of relapse occur in this arm, medication dose can be increased again. Measurements are conducted at baseline, at 3, and 6 months post-baseline, and yearly during a follow-up period of 4 years. Discussion The HAMLETT study will offer evidence to guide patients and clinicians regarding questions concerning optimal treatment duration and when to taper off medication after remission of a FEP. Moreover, it may provide patient characteristics associated with safe dose reduction with a minimal risk of relapse. Trial status Protocol version 1.3, October 2018. The study is active and currently recruiting patients (since September 2017), with the first 200 participants by the end of 2019. We anticipate completing recruitment in 2022 and final assessments (including follow-up 3.5 years after phase one) in 2026. Trial registration European Clinical Trials Database, EudraCT number 2017-002406-12. Registered 7 June 2017.
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Post by Admin on Feb 27, 2021 17:52:23 GMT
Discontinuing antipsychotic medication can be extremely difficult for service-users and comes with risks related to withdrawal and relapse. In a new study, psychologists Miriam Larsen-Barr and Fred Seymour from the University of Auckland in New Zealand take a close look at seven women’s experiences to shed light on the methods they used to taper these medications. “This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterward,” the authors write. Keys to Successful Discontinuation of Antipsychotic MedicationQualitative study finds that both internal resources and systemic factors play a role in antipsychotic discontinuation outcomes. www.madinamerica.com/2021/02/keys-successful-discontinuation-antipsychotic-medication/Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medicationMiriam Larsen-Barr, Fred SeymourFirst Published January 31, 2021 Research Article doi.org/10.1177/2045125321989133journals.sagepub.com/doi/10.1177/2045125321989133Abstract Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this. Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process. Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences. Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change. Keywords antipsychotic medication, bipolar disorder, medication withdrawal, psychosis, service-user research
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Post by Admin on Mar 19, 2021 18:29:42 GMT
First-hand experiences of taking antipsychotics: findings from a large online surveywww.nationalelfservice.net/treatment/antipsychotics/experiences-of-taking-antipsychotics/Antipsychotics (‘neuroleptics’) are primarily prescribed to people experiencing symptoms of psychosis, which broadly refers to a loss of contact with what most people consider as ‘reality’; symptoms can include hallucinations (e.g. hearing voices that others don’t hear) and delusions (fixed, false beliefs) (Arciniegas D., 2015). The evidence for antipsychotics largely comes from randomised controlled trials (RCTs) that predominantly assess ‘symptom reduction’ (Leucht S. et al, 2017). However, such trials may miss a lot of other factors by not considering the wider impacts of these drugs on people’s lives. Qualitative research that has explored people’s experiences with these medications has indicated a large number of physical side-effects, as well as difficulties with social and psychological functioning. However, this evidence is largely overlooked when evaluating the effectiveness of antipsychotics, and this may be partly due to the small number of participants. To address this, John Read and colleagues (2020) gathered responses from people around the world about what their experience of taking these medications has been like.
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Post by Admin on Mar 23, 2021 22:53:34 GMT
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Post by wynona on Apr 9, 2021 13:56:25 GMT
Ive tried withdrawing from antipsychotocs a couple times only to need hospitalization each time.
I think Ive developed a reliance on antipsychotics to avoid hallucinations and other psychotic symptoms.
Sometimes I wonder if I had avoided medication altogether if I would have avoided all my pscyhotic experiences.
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Post by Admin on Apr 9, 2021 13:56:32 GMT
Robert Whitaker: The Rising Non-Pharmaceutical Paradigm for "Psychosis"by The Education Committee of ISPS-US www.eventbrite.com/e/robert-whitaker-the-rising-non-pharmaceutical-paradigm-for-psychosis-tickets-148497370633Join ISPS-US for a webinar on April 22: Robert Whitaker: The Rising Non-Pharmaceutical Paradigm for "Psychosis" 2:00 PM – 1:30 PM EDT (New York time) Join us to learn how current research is questioning past assumptions on antipsychotics, and how nonpharmaceutical approaches are springing up globally. Starting in the 1980s, our society organized its thinking and systems of care around a “disease model” narrative that was promoted by the American Psychiatric Association and the pharmaceutical industry. That narrative has collapsed. The biology of mental disorders remains unknown; the diagnoses in the DSM have not been validated as discrete illnesses; the burden of “mental illness” in our society has risen; and there is an increasing body of evidence that tells of how psychiatric drugs, over the long-term, increase the chronicity of psychiatric disorders. The collapse of that paradigm provides an opportunity for radical change. In Norway, the health ministry has ordered that “medication—free” treatment be made available to psychiatric patients in hospital settings. A private hospital in Norway has opened that seeks to help chronic patients taper from their psychiatric drugs, or to be treated without the use of such drugs. In Israel, a number of “Soteria” houses have sprung up, which provide residential treatment to psychotic patients and minimize the use of antipsychotics in such settings. Research into Hearing Voice Networks is providing evidence of their “efficacy” for helping people recover. Open Dialogue treatment, which was developed in northern Finland and involved minimizing use of antipsychotics, is being adopted in many settings in the United States and abroad. In this webinar, Robert Whitaker tells of the science behind this paradigm shift: the science that tells of the failure of the disease model, and the science that provides a foundation for pilot programs underway in Norway, Israel and elsewhere. About the presenter: Robert Whitaker has written three books on the history of psychiatry: Mad in America, Anatomy of an Epidemic, and Psychiatry Under the Influence (the latter book he co-authored with Lisa Cosgrove.) He is the president of Mad in America Foundation, which—through its webzine, radio podcasts, continuing education webinars, and town halls—promotes an exploration of these issues. He is also on the adjunct faculty at Temple Medical School, in the psychiatry department. To register, please follow this link to eventbrite.
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Post by Admin on Apr 9, 2021 14:03:40 GMT
Ive tried withdrawing from antipsychotocs a couple times only to need hospitalization each time. I think Ive developed a reliance on antipsychotics to avoid hallucinations and other psychotic symptoms. Sometimes I wonder if I had avoided medication altogether if I would have avoided all my pscyhotic experiences. i think that this is part of the deep individuality & complexities of it all. i had a psychotic episode age 7 - certain symptoms of mental illness long before any contact with psychiatry & medication. Major psychosis age 17 - that lead to being very heavily medicated in hospital. Then stopped it all & was in full time work for 4 years. Then another major psychotic episode, eventual hospital again & medication. Then the same pattern again - stopped medication for another 4 years & was in full time work - re hospitalized / medicated - that was the pattern. Last 3 of my withdrawal attempts off medication were disastrous. i have now accepted medication for life. My argument has always been that if the treatment was better then maybe more people could recover / heal longer term medication free. Comprehensive community approaches to mental illness healingsanctuary.proboards.com/thread/3756/comprehensive-community-approaches-mental-illness?page=1& such approaches not as an either / or - But in combination to front end services / medication(s) if needed.
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Post by Admin on May 16, 2021 19:06:38 GMT
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Post by wynona on Jun 1, 2021 0:55:04 GMT
Im becoming more okay with my reliance on antipsychotics.
My only question is, how much sleep is normal on them? Is it normal to sleep over twelve hours a day?
But other than that, things have been fine. Ive been able to carry on a life that Im happy with.
I challenged myself to lose weight and despite being on meds, am losing.
To be honest, I think my initial resistance to antipsychotics had to do with this idea that Im owed a 'normal life'.
But we live in a rather crazy messed up world and to need some sort of help is really what's normal.
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Post by Admin on Jun 1, 2021 8:10:03 GMT
Im becoming more okay with my reliance on antipsychotics. My only question is, how much sleep is normal on them? Is it normal to sleep over twelve hours a day? But other than that, things have been fine. Ive been able to carry on a life that Im happy with. I challenged myself to lose weight and despite being on meds, am losing. To be honest, I think my initial resistance to antipsychotics had to do with this idea that Im owed a 'normal life'. But we live in a rather crazy messed up world and to need some sort of help is really what's normal. Yes this World is quite crazy. i suppose that a lot depends on the types / amounts of medications that you are on. i was on a very high dose of anti psychotic medication when i was 25, & slept a lot then.
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Post by wynona on Jun 2, 2021 20:40:08 GMT
Im becoming more okay with my reliance on antipsychotics. My only question is, how much sleep is normal on them? Is it normal to sleep over twelve hours a day? But other than that, things have been fine. Ive been able to carry on a life that Im happy with. I challenged myself to lose weight and despite being on meds, am losing. To be honest, I think my initial resistance to antipsychotics had to do with this idea that Im owed a 'normal life'. But we live in a rather crazy messed up world and to need some sort of help is really what's normal. Yes this World is quite crazy. i suppose that a lot depends on the types / amounts of medications that you are on. i was on a very high dose of anti psychotic medication when i was 25, & slept a lot then. I woke up today at 6am. That feels a lot better. I will try to wake up at that time from now on. Too much sleep during daylight hours makes me feel like Ive wasted some of the day.
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Post by Admin on Jul 21, 2021 17:20:35 GMT
Pragmatic recommendations were put forward by a team of researchers who delved into the controversies and debates surrounding antipsychotic medications (APM). David Roe and colleagues wrote a new open forum article in the journal Psychiatric Services to transform the research culture to center service users’ choices. To do this, they recommended a shift away from the focus on adherence and toward capturing diverse patterns of use employed by APM users to support their own recovery. “Individuals with long-term psychosis often do not share whether or how they are using APM [antipsychotic medication] nor the strategies they may utilize as alternatives to APM. In combination with overly simplistic, dichotomized measures of adherence, this tendency has arguably led to the impoverishment of research on APM use,” they write. Antipsychotic Adherence Research Overlooks Key InformationResearchers argue for a shift away from a focus on antipsychotic adherence toward understanding service users’ diverse patterns of use. www.madinamerica.com/2021/07/antipsychotic-adherence-research-overlooks-key-information/OPEN FORUMNo Access Conceptualization and Study of Antipsychotic Medication Use: From Adherence to Patterns of UseDavid Roe, Ph.D., Nev Jones, Ph.D., Ilanit Hasson-Ohayon, Ph.D., Yaara Zisman-Ilani, M.A., Ph.D. Published Online:15 Jun 2021https://doi.org/10.1176/appi.ps.202100006 ps.psychiatryonline.org/doi/10.1176/appi.ps.202100006Abstract Despite treatment guidelines recommending antipsychotic medication (APM) as the frontline treatment for schizophrenia, its use remains a controversial topic, and nonadherence rates range between 40% and 60%. At the heart of the debate lies a divergence of views about the tradeoffs between side effects and efficacy, particularly over the long term. This Open Forum describes a series of challenges pertaining to the conceptualization and operationalization of APM use. The authors suggest pragmatic recommendations oriented toward shifting the dialogue from often-polarized positions about APM to a transformed research culture prioritizing service users’ choices about diverse utilization patterns.
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Post by Admin on Mar 14, 2022 15:58:14 GMT
Antipsychotics Worsen Cognitive Functioning in First-Episode Psychosis Withholding antipsychotics may be beneficial for memory, the researchers write. By Peter Simons -March 14, 2022 www.madinamerica.com/2022/03/antipsychotics-worsen-cognitive-functioning-first-episode-psychosis/Antipsychotic Effects on Longitudinal Cognitive Functioning in First-Episode Psychosis: A randomised, triple-blind, placebo-controlled study View ORCID ProfileKelly Allott, Hok Pan Yuen, Lara Baldwin, Brian O’Donoghue, Alex Fornito, Sidhant Chopra, View ORCID ProfileBarnaby Nelson, Jessica Graham, Melissa J. Kerr, Tina Proffitt, Aswin Ratheesh, View ORCID ProfileMario Alvarez-Jimenez, View ORCID ProfileSusy Harrigan, Ellie Brown, Andrew D. Thompson, Christos Pantelis, Michael Berk, Patrick D. McGorry, Shona M. Francey, Stephen J. Wood doi: doi.org/10.1101/2022.02.16.22271103www.medrxiv.org/content/10.1101/2022.02.16.22271103v1
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Post by Admin on Mar 23, 2022 11:02:22 GMT
Antipsychotics Often Prescribed Without Informed Consent New research reveals that patients are often not given fully informed consent before being prescribed antipsychotics. By Samantha Lilly -March 23, 2022 www.madinamerica.com/2022/03/antipsychotics-often-prescribed-without-informed-consent/New research reveals that patients are often not given fully informed consent before being prescribed antipsychotics. The article, published by the Journal of Mental Health, reports on the challenges and realities of the prescribing process of antipsychotics (APs) for people with psychiatric diagnoses. The article is written by John Read, professor of clinical psychology at the University of East London. Read examines how APs are prescribed from the perspective of patients: “Even allowing for some forgetting by the respondents of what they were told, it seems the majority of prescribers are breaching the basic ethical principle of informed consent. The fact that hardly any of the 757 people were told about diabetes, sexual dysfunction, suicidality, potentially shortened life span, neuroleptic malignant syndrome (which is a life-threatening reaction to APs involving rapid onset fever and muscle rigidity), and none were told about withdrawal effects or reduced brain volume, might reasonably be described as negligent.” How important are informed consent, informed choice, and patient-doctor relationships, when prescribing antipsychotic medication? Article Read, J. 2022. How important are informed consent, informed choice, and patient-doctor relationships, when prescribing antipsychotic medication? Journal of Mental Health. repository.uel.ac.uk/item/8q5xx
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