14 DAY TRIAL // Early episodes of schizophrenia are treated today with anti-psychotics for at least a year. However, this medication often has serious side-effects, and it isn't entirely clear whether the medication is actually necessary. The side effects appear in nearly half of patients and include severe weight gain, restlessness, involuntary movement and adult-onset diabetes.
According to John Bola of the University of Southern California, "the question is whether we should rush to treat early episodes with anti-psychotics, often before a clear diagnosis has become evident". He questions whether or not treating the early episodes of schizophrenia has long lasting harmful effects for patients. He also said that in some cases schizophrenics can improve without medication and that in other cases medication doesn't seem to improve the condition of schizophrenics.
"It's important to look for the people who don't need medication to prevent overexposure to possible side effects," Bola said. "In the last 25 years, there has been little effort to identify the 25 to 40 percent of those who tend to recover with psychosocial treatment and not need medications."
"There is a lack of good-quality evidence to support a conclusion that long-term harm results from short-term postponement of medication in early episode schizophrenia," Bola said. "A categorical prohibition against such research should be reconsidered."
Another reason for eliminating such a prohibition is that using medication as soon as the first symptoms of schizophrenia appear prevents studying the illness in "natural conditions" and doesn't allow scientists to properly test the efficiency of different drugs.
Thomas H. McGlashan, director of the Yale Psychiatric Institute, who has been studying schizophrenia since the 1970s, wrote in one of the commentaries to Bola's study: "I maintain that our ignorance remains as profound as it was 29 years ago and that unraveling the mysteries of schizophrenia still requires observing it under natural conditions, i.e, without antipsychotic medications. On the other hand, medication has revolutionized the treatment of psychosis, and it is absolutely required under certain circumstances."