Zyprexa News

New Study Reveals Antipsychotic Drugs Like Zyprexa Not Always Needed

- March 22, 2006

Most psychiatrists have always believed the only way to manage schizophrenia is to immediately treat symptoms of psychosis with antipsychotic drugs like Zyprexa and Risperdal.

Some researchers also believe delaying drug treatment may potentially damage the brain.

However, a recent report indicates that when some people first begin to develop symptoms of psychosis such as hallucinations and imaginary voices, they can function without drugs-or with a significantly less amount than is normally prescribed-as well as they can with them.

The report was based on an analysis of six studies conducted from 1959 to 2003, which reveals the conflicting opinions in the psychiatry field.

In the last 20 years, doctors have treated people with antipsychotic medications aggressively and have even tested the drugs in an attempt to prevent psychosis in high-risk adolescents. Previous studies have shown that the drugs are found to be the best method to treat people who suffer from psychosis. Millions of Americans rely on the medications and the recent report most likely will not change anything.

But some psychiatrists believe the early drug treatments have gotten out of hand and may be harming patients who could deal with considerably less medication, possibly because they have mild forms of the condition.

"My personal view is that the pendulum has swung too far, and there's this knee-jerk reaction out there that says that any period of medication, even for research, is on the face of it unethical," said Dr. William Carpenter, editor of the journal Schizophrenia Bulletin and director of the University of Maryland's Psychiatric Research Center.

Dr. Carpenter believes that while drugs like Zyprexa and Risperdal are essential in the treatment of most cases of psychosis, the field's insistent use of the medications leave "little maneuvering room" to test different options. "It's a very controversial issue," he said.

Other experts, however, said that the new report's findings were dangerous because they only interpreted one side of the evidence. "I am usually a pretty moderate person," said Dr. Jeffrey Lieberman, chairman of psychiatry at Columbia University Medical Center and director of the New York State Psychiatric Institute. "But on this I am 110 percent emphatic: If the diagnosis is clear, not treating with medication is a huge mistake that risks the person's best chance at recovery."

In the report, John Bola, assistant professor of social work at the University of Southern California, evaluated six long-term studies of 623 people who had symptoms of psychosis. He found there were a group of patients who responded well to drug-free treatments. He believes these implications show "that we need to be additionally careful about medicating people after their first psychotic episode if there's reason to think they could" function without drugs.

The studies reveal that 10 to 40 percent of people suffering from symptoms of psychosis can handle the condition without medication. However, there is no test to determine these people, so many doctors believe withholding these drugs after a psychotic episode is very risky.

Despite the two sides of the debate, experts do agree that more research is needed to determine the best form of treatment for patients. "My bottom line is that this is a very challenging illness, every patient is different, and we need more research to inform decisions about how to individualize care," said Dr. John Kane, chairman of the psychiatry department of Zucker Hillside Hospital in New York.

He added that with certain patients "we have to be very careful about making blanket statements about which treatment is best."

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