Family and Caregiver Schizophrenia Discussion Forum

Baseline off medication


#1

Just wondering if anyone has ever heard that everytime a person goes off their meds, their baseline gets lower?


#2

Yes, I have heard that. I don’t think it is a guaranteed result, but it is definitely considered a possible outcome.


#3

I have tried to understand what is meant by baseline for a long time.

I just googled it again and am not clear on the concept.

Is there a layperson’s definition that you could tell me?

Thank you, hope all is well.


#4

As I understand it, a person’s ‘baseline’ is considered to be “the best they are going to get”. It has been a big source of irritation for me, because I feel it is sometimes used as an excuse to stop trying to do more. “He has returned to his baseline, time to discharge from the hospital.”

Supposedly, my son’s baseline at one point was that he was going to experience unrelenting internal stimuli. But with clozapine, that isn’t the case anymore. Now his baseline seems to be - will hold to many delusions. I understand delusions are harder to be done with than the internal stimuli, and I don’t spend a lot of time anymore worrying about the fact that he has them, but I also don’t necessarily accept that ‘this is as good as it gets’. My sense is, the longer he is stable, the better chances we have at improving his ‘baseline’.

In the context of the current discussion, the accepted idea is that each time a person goes off their meds and ‘decompensates’ - experiences increased and worsening symptoms - the more likely they will be unable to return to the same level of functioning they were at before they went off their meds. I think this is based on the thought that some kind of irreversible brain changes occur when a person returns to psychosis.


#5

So is this a fact that irreversible brain damage is done each time someone goes into psychosis?


#6

@Rinda, I would not say it is a fact. I think clinical observation that many people who go off their meds and decompensate do not return to their previous level of function has lead to this being a commonly held belief, and is often used as a reason to stay on meds. There may be some research to support it as well, but I can’t cite any.

In reality, I think there are few known ‘facts’ about schizophrenia. To me, given what I observe my son go thru when he is experiencing psychosis, it seems reasonable that some kind of changes in the brain are quite possible.


#7

Even if this has tended to be the case for many people, it doesn’t mean it is automatically true for everyone. There IS evidence that psychosis causes brain damage, and that each episode primes the brain fir the next one. But, in contrast, there is also evidence that the brain is ‘plastic’ or capable of development right up to the day we die. So we have two opposing forces at work. We need to work on the plasticity part. Just as with non-sz people, diet can be anti-inflammatory (the brain seems to be inflamed in some psychosis) and some foods (fish, for example) help with brain and CNS building. Exercise is another. One of the outstanding ‘survivors’ on the Duagnosed board is Mortimermouse, who is seriously into weights and body building. Other survivors surf, run, go to the gym, do yard work, etc, etc. Running is known to be good for building intelligence and memory. Exercise is also anti-inflammatory. Then lately there is the research on sarcosine, which says it actually repairs the damage done to the brain when used in tandem with APs.

These are the strategies I encourage my son to use.