Schizophrenia |
Low Dose Lithium
Dr. James Greenblatt is a forerunner in the field of integrative and nutritional psychiatry with almost 30 years of experience treating patients, and employing nutritional interventions to relieve symptoms. He is the Chief Medical Officer at Walden Behavioral Care in Waltham, MA and is also an Assistant Clinical Professor of Psychiatry at Tufts University School of Medicine and Dartmouth College Geisel School of Medicine. He regularly participates in national speaking engagements and educational webinars, and is the author of multiple books, including Answers to Anorexia (2011), Answers to Binge Eating (2014), Integrative Therapies for Depression: Redefining Models for Assessment, Treatment, and Prevention (2015), Nutritional Lithium: The Cinderella Story (2016), The Breakthrough Depression Solution 2nd ed. (2016), and Finally Focused (2017).
Don't Miss Our Lithium Webinars!
Join us February 12th and 26th, 2018 at 7:00 pm EST for two, 1-hour webinars
Low-Dose Nutritional Lithium: Clinical Protocols for Mental Illness and Mental Health
Explore the scientific research in the clinical applications of low-dose lithium and learn clinical and laboratory assessment methods to determine the appropriate treatment strategies and manage side effects.
Low-dose Lithium - 1 to 150 mg - can be an effective therapeutic strategy for irritability, aggression, mood disorders, Lyme, ADHD, Parkinson's, and Alzheimer's Disease.
Click Here to Register - Only $79 for both webinars
Dr. James Greenblatt is a forerunner in the field of integrative and nutritional psychiatry with almost 30 years of experience treating patients, and employing nutritional interventions to relieve symptoms. He is the Chief Medical Officer at Walden Behavioral Care in Waltham, MA and is also an Assistant Clinical Professor of Psychiatry at Tufts University School of Medicine and Dartmouth College Geisel School of Medicine. He regularly participates in national speaking engagements and educational webinars, and is the author of multiple books, including Answers to Anorexia (2011), Answers to Binge Eating (2014), Integrative Therapies for Depression: Redefining Models for Assessment, Treatment, and Prevention (2015), Nutritional Lithium: The Cinderella Story (2016), The Breakthrough Depression Solution 2nd ed. (2016), and Finally Focused (2017).
Don't Miss Our Lithium Webinars!
Join us February 12th and 26th, 2018 at 7:00 pm EST for two, 1-hour webinars
Low-Dose Nutritional Lithium: Clinical Protocols for Mental Illness and Mental Health
Explore the scientific research in the clinical applications of low-dose lithium and learn clinical and laboratory assessment methods to determine the appropriate treatment strategies and manage side effects.
Low-dose Lithium - 1 to 150 mg - can be an effective therapeutic strategy for irritability, aggression, mood disorders, Lyme, ADHD, Parkinson's, and Alzheimer's Disease.
Click Here to Register - Only $79 for both webinars
Schizophrenia Research
Have schizophrenia or care for someone who does?
Help inform better medications by sharing your experiences with increased or more intense symptoms of schizophrenia that may have led to hospitalization or community-based treatment—either as a person with schizophrenia or as a caregiver.
Your responses will provide real-life insights that will help research into medications that may help symptoms of schizophrenia from getting worse.
If you qualify and complete the anonymous research survey, you will receive a $50 Visa gift card.
If you’re interested or have questions, email us at researchstudy@nami.org or call us at (888) 780-4167.
The deadline to see if you qualify for the research study is March 13th, 2017. So, email or call today!
What do you need to take part in the research study?
Happy Carlock
Coordinator
Advocacy & Public Policy
NAMI, National Alliance on Mental Illness
3803 N. Fairfax Dr., Suite 100
Arlington, VA 22203
Main: 703-524-7600
Direct: (703) 600-1107
Have schizophrenia or care for someone who does?
Help inform better medications by sharing your experiences with increased or more intense symptoms of schizophrenia that may have led to hospitalization or community-based treatment—either as a person with schizophrenia or as a caregiver.
Your responses will provide real-life insights that will help research into medications that may help symptoms of schizophrenia from getting worse.
If you qualify and complete the anonymous research survey, you will receive a $50 Visa gift card.
If you’re interested or have questions, email us at researchstudy@nami.org or call us at (888) 780-4167.
The deadline to see if you qualify for the research study is March 13th, 2017. So, email or call today!
What do you need to take part in the research study?
- An email address
- Mailing address (so we can send you your $50 Visa gift card)
- Internet access and a smartphone, tablet or computer
- Be willing to answer questions about your experience with increased or more intense symptoms of schizophrenia that may have led to hospitalization or community-based treatment—either as someone with schizophrenia or caring for somebody with schizophrenia
Happy Carlock
Coordinator
Advocacy & Public Policy
NAMI, National Alliance on Mental Illness
3803 N. Fairfax Dr., Suite 100
Arlington, VA 22203
Main: 703-524-7600
Direct: (703) 600-1107
Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness, affecting about 1% of Americans. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia.
Symptoms
It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the "prodromal" period.
With any condition, it's essential to get a comprehensive medical evaluation in order to obtain the best diagnosis. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for a least 6 months:
Causes
Research suggests that schizophrenia may have several possible causes:
Diagnosis
Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have schizophrenia-like symptoms. The difficulty of diagnosing this illness is compounded by the fact that many people who are diagnosed do not believe they have it. Lack of awareness is a common symptom of people diagnosed with schizophrenia and greatly complicates treatment.
While there is no single physical or lab test that can diagnosis schizophrenia, a health care provider who evaluates the symptoms and the course of a person's illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as brain tumors, possible medical conditions and other psychiatric diagnoses, such as bipolar disorder.
To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:
People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens she is looking through. African Americans and Latinos are more likely to be misdiagnosed, probably due to differing cultural or religious beliefs or language barriers. Any person who has been diagnosed with schizophrenia should try to work with a health care professional that understands his or her cultural background and shares the same expectations for treatment.
Treatment
There is no cure for schizophrenia, but it can be treated and managed in several ways.
Related Conditions
People with schizophrenia may have additional illnesses. These may include:
Substance abuse
Posttraumatic stress disorder
Obsessive-compulsive disorder
Major depression
Successfully treating schizohprenia almost always improves these related illnesses. And successful treatment of substance abuse, PTSD or OCD usually improves the symptoms of schizophrenia.
Symptoms
It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the "prodromal" period.
With any condition, it's essential to get a comprehensive medical evaluation in order to obtain the best diagnosis. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for a least 6 months:
- Hallucinations. These include a person hearing voices, seeing things, or smelling things others can’t perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for a loved one to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.
- Delusions. These are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
- Negative symptoms are ones that diminish a person’s abilities. Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.
- Cognitive issues/disorganized thinking. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks. Commonly, people with schizophrenia have anosognosia or “lack of insight.” This means the person is unaware that he has the illness, which can make treating or working with him much more challenging.
Causes
Research suggests that schizophrenia may have several possible causes:
- Genetics. Schizophrenia isn’t caused by just one genetic variation, but a complex interplay of genetics and environmental influences. While schizophrenia occurs in 1% of the general population, having a history of family psychosis greatly increases the risk. Schizophrenia occurs at roughly 10% of people who have a first-degree relative with the disorder, such as a parent or sibling. The highest risk occurs when an identical twin is diagnosed with schizophrenia. The unaffected twin has a roughly 50% chance of developing the disorder.
- Environment. Exposure to viruses or malnutrition before birth, particularly in the first and second trimesters has been shown to increase the risk of schizophrenia. Inflammation or autoimmune diseases can also lead to increased immune system
- Brain chemistry. Problems with certain brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neurotransmitters allow brain cells to communicate with each other. Networks of neurons are likely involved as well.
- Substance use. Some studies have suggested that taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk. Another study has found that smoking marijuana led to earlier onset of schizophrenia and often preceded the manifestation of the illness.
Diagnosis
Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have schizophrenia-like symptoms. The difficulty of diagnosing this illness is compounded by the fact that many people who are diagnosed do not believe they have it. Lack of awareness is a common symptom of people diagnosed with schizophrenia and greatly complicates treatment.
While there is no single physical or lab test that can diagnosis schizophrenia, a health care provider who evaluates the symptoms and the course of a person's illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as brain tumors, possible medical conditions and other psychiatric diagnoses, such as bipolar disorder.
To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized or catatonic behavior
- Negative symptoms
- Delusions or hallucinations alone can often be enough to lead to a diagnosis of schizophrenia. Identifying it as early as possible greatly improves a person’s chances of managing the illness, reducing psychotic episodes, and recovering. People who receive good care during their first psychotic episode are admitted to the hospital less often, and may require less time to control symptoms than those who don’t receive immediate help. The literature on the role of medicines early in treatment is evolving, but we do know that psychotherapy is essential.
People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens she is looking through. African Americans and Latinos are more likely to be misdiagnosed, probably due to differing cultural or religious beliefs or language barriers. Any person who has been diagnosed with schizophrenia should try to work with a health care professional that understands his or her cultural background and shares the same expectations for treatment.
Treatment
There is no cure for schizophrenia, but it can be treated and managed in several ways.
- Antipsychotic medications
- Psychotherapy, such as cognitive behavioral therapy and assertive community treatment and supportive therapy
- Self-management strategies and education
Related Conditions
People with schizophrenia may have additional illnesses. These may include:
Substance abuse
Posttraumatic stress disorder
Obsessive-compulsive disorder
Major depression
Successfully treating schizohprenia almost always improves these related illnesses. And successful treatment of substance abuse, PTSD or OCD usually improves the symptoms of schizophrenia.
September 6, 2016
Opportunity for people living with schizophrenia and family caregivers to help improve medications for schizophrenia .
Do you know people, including program participants or volunteers, who may be interested in improving medications for schizophrenia? If so, please forward the image and message below.
Are you interested in improving the quality of medications for schizophrenia? If you live with schizophrenia or are a caregiver of someone who does, we have an opportunity for you.
NAMI is working with a pharmaceutical company that is researching a new medication that targets early symptoms of schizophrenia. We are looking for adults who would like to answer an anonymous survey on their experiences with schizophrenia to help inform the research.
If you’re interested, call us (888-780-4167) or email us (researchstudy@nami.org) and we’ll ask you a few brief questions. If you qualify, you’ll be emailed a link to participate in NAMI’s Virtual Advisory Panel where you’ll take a survey and, if you like, share comments or advice.
Note: To participate in Virtual Advisory Panel, you’ll need access to the internet through a computer, tablet or smartphone at the time of the survey.
We value your time and lived experience. Individuals who complete the survey will receive a $50 Visa gift card.
Thank you for improving the quality of medications for schizophrenia. Questions? Please contact us at researchstudy@nami.org.
Opportunity for people living with schizophrenia and family caregivers to help improve medications for schizophrenia .
Do you know people, including program participants or volunteers, who may be interested in improving medications for schizophrenia? If so, please forward the image and message below.
Are you interested in improving the quality of medications for schizophrenia? If you live with schizophrenia or are a caregiver of someone who does, we have an opportunity for you.
NAMI is working with a pharmaceutical company that is researching a new medication that targets early symptoms of schizophrenia. We are looking for adults who would like to answer an anonymous survey on their experiences with schizophrenia to help inform the research.
If you’re interested, call us (888-780-4167) or email us (researchstudy@nami.org) and we’ll ask you a few brief questions. If you qualify, you’ll be emailed a link to participate in NAMI’s Virtual Advisory Panel where you’ll take a survey and, if you like, share comments or advice.
Note: To participate in Virtual Advisory Panel, you’ll need access to the internet through a computer, tablet or smartphone at the time of the survey.
We value your time and lived experience. Individuals who complete the survey will receive a $50 Visa gift card.
Thank you for improving the quality of medications for schizophrenia. Questions? Please contact us at researchstudy@nami.org.
Seeking Participants! Genetics Research Study on Schizophrenia
Our study is designed to help determine the specific gene or sequence of genes responsible for this debilitating disorder. Once found, this information can then be used to develop better ways of detecting and treating this illness, and to hopefully one day find a cure.
We are searching for families with a history of schizophrenia and related disorders, that is, at least three (3) members of the extended family must have each been diagnosed with one of the following:
• Schizophrenia
• Schizoaffective disorder
• Schizotypal personality disorder
• Bipolar disorder with psychotic features
Family members can come from multiple generations, including siblings, parents, aunts, uncles, grandparents, etc. They must live in the U.S., be over 18 years old and be willing to participate in the study. While our research team is based at the VA Medical Center in Brockton, Massachusetts, family members do not have to be veterans and they can be located anywhere in the continental U.S.
The study itself is very simple: it consists of a clinical interview and donating a blood sample, which our research assistant conducts right in the family member’s home. Once completed, each participant receives a check for $130.00.
You’ll find attached a descriptive flier which can be used as a handout and a flier designed to be posted on bulletin boards. I’m hoping that you’ll be willing to distribute and post these fliers so that your volunteers, consumers and family members can learn about this important study. You can also read about the study online by visiting Center Watch (click here). This study has been reviewed by Dr. Ken Duckworth, Medical Director of NAMI, and listed on the NAMI National website. Click here for our recruitment flyer.
Your help is very much needed and greatly appreciated. Please don’t hesitate to contact me if you have any questions or would like to discuss further.
Best regards,
Paul Nelson, M.Ed.
Clinical Research Coordinator
VA Boston Healthcare System
940 Belmont St.
Brockton, MA 02301
845-981-9514 Info Hotline
paul.nelson2@va.gov
Our study is designed to help determine the specific gene or sequence of genes responsible for this debilitating disorder. Once found, this information can then be used to develop better ways of detecting and treating this illness, and to hopefully one day find a cure.
We are searching for families with a history of schizophrenia and related disorders, that is, at least three (3) members of the extended family must have each been diagnosed with one of the following:
• Schizophrenia
• Schizoaffective disorder
• Schizotypal personality disorder
• Bipolar disorder with psychotic features
Family members can come from multiple generations, including siblings, parents, aunts, uncles, grandparents, etc. They must live in the U.S., be over 18 years old and be willing to participate in the study. While our research team is based at the VA Medical Center in Brockton, Massachusetts, family members do not have to be veterans and they can be located anywhere in the continental U.S.
The study itself is very simple: it consists of a clinical interview and donating a blood sample, which our research assistant conducts right in the family member’s home. Once completed, each participant receives a check for $130.00.
You’ll find attached a descriptive flier which can be used as a handout and a flier designed to be posted on bulletin boards. I’m hoping that you’ll be willing to distribute and post these fliers so that your volunteers, consumers and family members can learn about this important study. You can also read about the study online by visiting Center Watch (click here). This study has been reviewed by Dr. Ken Duckworth, Medical Director of NAMI, and listed on the NAMI National website. Click here for our recruitment flyer.
Your help is very much needed and greatly appreciated. Please don’t hesitate to contact me if you have any questions or would like to discuss further.
Best regards,
Paul Nelson, M.Ed.
Clinical Research Coordinator
VA Boston Healthcare System
940 Belmont St.
Brockton, MA 02301
845-981-9514 Info Hotline
paul.nelson2@va.gov
NAMI Update, April 15, 2016
Schizophrenia: Digital Technology Defies Stigma, Supports Recovery
ARLINGTON, Va., April 15, 2016 /PRNewswire-USNewswire/ -- The National Alliance on Mental Illness (NAMI) has released the results of a survey showing that people living with schizophrenia use digital technology generally as much as the rest of the population—and in ways that help them cope with the effects of their condition.
The survey is also analyzed in the latest issue of JMIR Mental Health in the article "Digital Technology Use Among Individuals with Schizophrenia: Results from a NAMI Survey." The authors include NAMI's National Communications Director and Public Affairs Katrina Gay, NAMI Medical Director Ken Duckworth and former NAMI National Board PresidentAnand Pandya, M.D.
See NAMI survey page, including a power point presentation and a link to the JMIR article (requires website registration). The article citation is JMIR Mental Health 2016;3(2):e15.
The study is the largest to date looking at ownership and use of technology among individuals living with schizophrenia.
"Individuals living with schizophrenia may face a double stigma when using digital devices," the study notes. "Beyond the stigma often associated with schizophrenia itself, there may be bias that those living with schizophrenia do not own, cannot use, are not interested in, or will become more paranoid and agitated when using technologies like mobile phones."
The survey was conducted online, Aug. 25 to Sept. 8, 2014, and involved 457 respondents.
Schizophrenia is a long-term mental illness that interferes with a person's ability to think clearly, manage emotions, make decisions and relate to others. It may include visual or auditory hallucinations and delusional beliefs. It affects about 1% of Americans. The average age of onset is in the late teens to the early 20s for men, and the late 20s to early 30s for women.
Schizophrenia: Digital Technology Defies Stigma, Supports Recovery
ARLINGTON, Va., April 15, 2016 /PRNewswire-USNewswire/ -- The National Alliance on Mental Illness (NAMI) has released the results of a survey showing that people living with schizophrenia use digital technology generally as much as the rest of the population—and in ways that help them cope with the effects of their condition.
The survey is also analyzed in the latest issue of JMIR Mental Health in the article "Digital Technology Use Among Individuals with Schizophrenia: Results from a NAMI Survey." The authors include NAMI's National Communications Director and Public Affairs Katrina Gay, NAMI Medical Director Ken Duckworth and former NAMI National Board PresidentAnand Pandya, M.D.
See NAMI survey page, including a power point presentation and a link to the JMIR article (requires website registration). The article citation is JMIR Mental Health 2016;3(2):e15.
The study is the largest to date looking at ownership and use of technology among individuals living with schizophrenia.
- 90% of the individuals surveyed owned more than one digital device such as a personal computer, tablet or smartphone.
- 54% had access to smartphones compared to 64% of all Americans.
- 42% by blocking or managing auditory hallucinations with music or audio files
- 38% for health information on the Internet
- 37% for calendar reminders
- 32% for transportation and map needs
- 28% for medication management
- 26% for supporting others
- 26% for developing relationships with other persons with schizophrenia
- 25% for monitoring symptoms
- 24% for identifying coping strategies.
"Individuals living with schizophrenia may face a double stigma when using digital devices," the study notes. "Beyond the stigma often associated with schizophrenia itself, there may be bias that those living with schizophrenia do not own, cannot use, are not interested in, or will become more paranoid and agitated when using technologies like mobile phones."
The survey was conducted online, Aug. 25 to Sept. 8, 2014, and involved 457 respondents.
Schizophrenia is a long-term mental illness that interferes with a person's ability to think clearly, manage emotions, make decisions and relate to others. It may include visual or auditory hallucinations and delusional beliefs. It affects about 1% of Americans. The average age of onset is in the late teens to the early 20s for men, and the late 20s to early 30s for women.
Schizophrenia and the Synapse
Genetic evidence suggests that overactive synaptic pruning drives development of schizophrenia.
By Ruth Williams | January 27, 2016
Compared to the brains of healthy individuals, those of people with schizophrenia have higher expression of a gene called C4, according to a paper published in Nature today (January 27). The gene encodes an immune protein that moonlights in the brain as an eradicator of unwanted neural connections (synapses). Synaptic pruning is a normal part of development and is thought to reflect the process of learning, where the brain strengthens some connections and eradicates others. Interestingly, the brains of deceased schizophrenia patients exhibit reduced neuron density. The new results, therefore, “make a lot of sense,” said Cardiff University’s Andrew Pocklington who did not participate in the work. They also make sense “in terms of the time period when synaptic pruning is occurring, which sort of overlaps with the period of onset for schizophrenia: around adolescence and early adulthood,” he added.
Click here for the full story.
Genetic evidence suggests that overactive synaptic pruning drives development of schizophrenia.
By Ruth Williams | January 27, 2016
Compared to the brains of healthy individuals, those of people with schizophrenia have higher expression of a gene called C4, according to a paper published in Nature today (January 27). The gene encodes an immune protein that moonlights in the brain as an eradicator of unwanted neural connections (synapses). Synaptic pruning is a normal part of development and is thought to reflect the process of learning, where the brain strengthens some connections and eradicates others. Interestingly, the brains of deceased schizophrenia patients exhibit reduced neuron density. The new results, therefore, “make a lot of sense,” said Cardiff University’s Andrew Pocklington who did not participate in the work. They also make sense “in terms of the time period when synaptic pruning is occurring, which sort of overlaps with the period of onset for schizophrenia: around adolescence and early adulthood,” he added.
Click here for the full story.
October 20, 2015
NYTimes.com »
Breaking News Alert
A landmark schizophrenia study recommends lowering drug dosages and increasing therapy
By BENEDICT CAREY OCT. 20, 2015
More than two million people in the United States have a diagnosis of schizophrenia, and the treatment for most of them mainly involves strong doses of antipsychotic drugs that blunt hallucinations and delusions but can come with unbearable side effects, like severe weight gain or debilitating tremors.
Now, results of a landmark government-funded study call that approach into question. The findings, from by far the most rigorous trial to date conducted in the United States, concluded that schizophrenia patients who received smaller doses of antipsychotic medication and a bigger emphasis on one-on-one talk therapy and family support made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.
The report, to be published on Tuesday in The American Journal of Psychiatry and funded by the National Institute of Mental Health, comes as Congress debates mental health reform and as interest in the effectiveness of treatments grows amid a debate over the possible role of mental illness in mass shootings.
Its findings have already trickled out to government agencies: On Friday, the Centers for Medicare &Medicaid Services published in its influential guidelines a strong endorsement of the combined-therapy approach. Mental health reform bills now being circulated in Congress “mention the study by name,” said Dr. Robert K. Heinssen, the director of services and intervention research at the centers, who oversaw the research.
In 2014, Congress awarded $25 million in block grants to the states to be set aside for early-intervention mental health programs. So far, 32 states have begun using those grants to fund combined-treatment services, Dr. Heinssen said.
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 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.
The drugs used to treat schizophrenia, called antipsychotics, work extremely well for some people, eliminating psychosis with few side effects; but most who take them find that their bad effects, whether weight gain, extreme drowsiness, or emotional numbing, are hard to live with. Nearly three quarters of people prescribed medications for the disorder stop taking them within a year and a half, studies find.
“As for medications, I have had every side effect out there, from chills and shakes to lockjaw and lactation,” said a participant in the trial, Maggie, 20, who asked that her last name be omitted. She did well in the trial and is now attending nursing school.
Read more »
NYTimes.com »
Breaking News Alert
A landmark schizophrenia study recommends lowering drug dosages and increasing therapy
By BENEDICT CAREY OCT. 20, 2015
More than two million people in the United States have a diagnosis of schizophrenia, and the treatment for most of them mainly involves strong doses of antipsychotic drugs that blunt hallucinations and delusions but can come with unbearable side effects, like severe weight gain or debilitating tremors.
Now, results of a landmark government-funded study call that approach into question. The findings, from by far the most rigorous trial to date conducted in the United States, concluded that schizophrenia patients who received smaller doses of antipsychotic medication and a bigger emphasis on one-on-one talk therapy and family support made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.
The report, to be published on Tuesday in The American Journal of Psychiatry and funded by the National Institute of Mental Health, comes as Congress debates mental health reform and as interest in the effectiveness of treatments grows amid a debate over the possible role of mental illness in mass shootings.
Its findings have already trickled out to government agencies: On Friday, the Centers for Medicare &Medicaid Services published in its influential guidelines a strong endorsement of the combined-therapy approach. Mental health reform bills now being circulated in Congress “mention the study by name,” said Dr. Robert K. Heinssen, the director of services and intervention research at the centers, who oversaw the research.
In 2014, Congress awarded $25 million in block grants to the states to be set aside for early-intervention mental health programs. So far, 32 states have begun using those grants to fund combined-treatment services, Dr. Heinssen said.
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 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.
The drugs used to treat schizophrenia, called antipsychotics, work extremely well for some people, eliminating psychosis with few side effects; but most who take them find that their bad effects, whether weight gain, extreme drowsiness, or emotional numbing, are hard to live with. Nearly three quarters of people prescribed medications for the disorder stop taking them within a year and a half, studies find.
“As for medications, I have had every side effect out there, from chills and shakes to lockjaw and lactation,” said a participant in the trial, Maggie, 20, who asked that her last name be omitted. She did well in the trial and is now attending nursing school.
Read more »
