Tuesday, June 21, 2011

Best practice for short term use of neuroleptic medication

Here's a question that's been puzzling me. There is a growing consensus that says that neuroleptic medication, if administered at all, should be of short duration and used only when and if necessary during periods of acute psychosis.

My question is, where is the best practice that defines "short term?" Are we talking one month, three months, one year maximum? What is meant by "short term?"

Does anyone out there have some information on this topic?

7 comments:

  1. Hi

    I consider myself to have recovered from schizophrenia (although I hate the word and its implications, I have to acknowledge that I was very ill). I have just found your blog, it looks fasciating. I am wondering if it might help you or your son to look at mine 'schizophreniaattheschoolgate'. You might find the early posts (which have more information about what I went through and how I have coped with it) interesting. I hope so.

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  2. Thanks for your comment and welcome to this blog. I'll check out your posts.

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  3. I wouldn't recommend neuroleptic drugs under any circumstances.

    With a supportive, trusting, and caring environment I have observed the symptoms of acute psychosis pass on their own. It may take several months for this to occur however I believe the outcome is better than that obtained by administering the drugs. My view is that the experience of uninterrupted psychosis can result in personal growth for the individual who has experienced it. Drugs abate that opportunity for personal growth.

    The problem with short term neuroleptic drug administration is one then needs to withdraw from the drugs and the withdrawl process causes problems as well, including the risk for tardive psychosis and a bunch of other negative psychological effects, including the risk for suicidal ideologue.

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  4. That may be so, but that's in an ideal world. I've done the homemade Soteria thing and I had six months of psychosis to deal with before Chris went back into the hospital and was put on a neuroleptic. Consider a typical scenario. Your relative winds up in the emergency room of the hospital and hospitalized for the first time or the tenth time. It is unlikely your relative will get out of the hospital without their administering antipsychotcs. This is unfortunately what happens when there is no incentive for the medical profession to work with other solutions. So, there you are. You say to the doctors, I want him off these drugs as soon as possible after he's released. Give me a date when he should be off them. What advice am I going to get as to what is "short term" use of an antipsychotic?

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  5. I couldn't agree more, but it wreaks havoc with the family. This is where there should be more information made available to teach the family members how to respond.

    "My view is that the experience of uninterrupted psychosis can result in personal growth for the individual who has experienced it. Drugs abate that opportunity for personal growth."

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  6. when I talk short term drug use I mean one day at a time to allow for sleep...sleep is the only thing that on some occasions must be allowed for...and those who are opposed to that too don't really know what can happen...even soteria drugs on those occasions, though they use benzos...

    spot use like this will not stop the overall healing process.

    ideally it's better to let the psychosis come through and be processed...unfortunately there are rarely places where that is safe and that is why drugs are used so frequently...

    when someone is up against an unsafe environment...drugs are sometimes the lesser of two evils...and there is no shame in that.

    we must remember we have not traveled in anyone's shoes but our own...we cannot dictate what is right for another.

    context is everything.

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  7. "Context is everything"

    I agree, but since neuroleptics are very powerful drugs, shouldn't there be factual information available (best practice) that backs up this new thinking that says that medication should be short term? If we don't define it, it slips away from us. (Pharma would love this, of course!)

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