Massive gov't study promotes smaller drug doses, more talk therapy for schizophrenia
- A massive, 7-year government-sponsored study that is being hailed as a "landmark" recommends earlier intervention and a combined approach to treating schizophrenia that relies less on high drug doses and more on talk therapy.
- The study was sponsored by the National Institute of Mental Health (NIMH) and conducted in real-world settings—i.e., in 34 actual mental health community care centers across 21 states.
- Healthcare providers at these facilities were trained to help patients on multiple levels, including by assisting them with school- and work-related decisions; educating family members on the contours of the disease; and one-on-one talk therapy that's highly tailored towards an individual's specific symptoms. With that combined approach, care givers also slashed the dosage of schizophrenia medication they gave patients by as much as half, thereby reducing the incidence of adverse effects like tremors, spasms, and weight gain.
The two major takeaways from the study are that 1) earlier intervention after a patient's first psychotic break is correlated with a much higher incidence of successful disease management and 2) a more aggressive, personalized approach to therapy negates the need for high drug doses that may come with major side effects.
Atypical antipsychotics such as Otsuka's Abilify and Novartis' Clozaril have been largely successful in controlling symptoms and preventing psychotic breaks in schizophrenia patients, and the number one reason for patients' relapse is discontinuing medication. But patients have often pointed to side effects that are disruptive at best and debilitating at worst at higher doses of these drugs, including involuntary spasms, emotional numbness, and rapid weight gain.
Doctors who were not involved with the study praised its results, saying that lower reliance on high drug doses and more focused talk therapy is a far more preferable treatment regimen. Over the next years and decades, it will be fascinating to watch if this early-intervention, combined therapy approach really takes off, and how effective it is in minimizing psychotic events.