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Does treatment of schizophrenia with antipsychotic medications eliminate or reduce psychosis? A 20-year multi-follow-up study

Published online by Cambridge University Press:  24 March 2014

M. Harrow ,
T. H. Jobe  and
R. N. Faull
M. Harrow*
Affiliation:
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
T. H. Jobe
Affiliation:
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
R. N. Faull
Affiliation:
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
*
* Address for correspondence: M. Harrow, Ph.D., Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor Street (M/C 912), Chicago, IL 60612, USA. (Email: Mharrow@psych.uic.edu)
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Abstract

Background

This research assesses whether multi-year treatment with antipsychotic medications reduces or eliminates psychosis in schizophrenia. It provides 20 years of longitudinal data on the frequency and severity of psychotic activity in samples of schizophrenia patients (SZ) treated versus those not treated with antipsychotic medications.

Method

A total of 139 early young schizophrenia and mood-disordered patients were assessed at index hospitalization and then reassessed six times over 20 years for psychosis and other major variables.

Results

At each follow-up assessment over the 20 years, a surprisingly high percentage of SZ treated with antipsychotics longitudinally had psychotic activity. More than 70% of SZ continuously prescribed antipsychotics experienced psychotic activity at four or more of six follow-up assessments over 20 years. Longitudinally, SZ not prescribed antipsychotics showed significantly less psychotic activity than those prescribed antipsychotics (p < 0.05).

Conclusions

The 20-year data indicate that, longitudinally, after the first few years, antipsychotic medications do not eliminate or reduce the frequency of psychosis in schizophrenia, or reduce the severity of post-acute psychosis, although it is difficult to reach unambiguous conclusions about the efficacy of treatment in purely naturalistic or observational research. Longitudinally, on the basis of their psychotic activity and the disruption of functioning, the condition of the majority of SZ prescribed antipsychotics for multiple years would raise questions as to how many of them are truly in remission.

Keywords

Antipsychotic medicationslongitudinalpsychosisschizophreniatreatment
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 14 , October 2014 , pp. 3007 - 3016
Copyright
Copyright © Cambridge University Press 2014 

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