Family and Caregiver Schizophrenia Discussion Forum

What’s happen without treatment

Hello everyone
Does anyone knows what happened if his beloved schysophrenic doesn’t take treatment for a long term
I read all your stories and it seems that sometimes medications make the illness worse

Hi, Rida,
I wrote a reply and then realized I think I misunderstood your post.

I am sending positive thoughts!!

Some people think that schizophrenia will get continuously worse if meds are not taken, that with each psychotic episode the disease gets worse, and that by preventing psychoses the brain is protected by the meds. Also, medication prevents worse things like suicide and imprisonment for violent behavior. A proponent of this view is the Treatment Advocacy Center

There is also a sizable anti-medication camp who believe the drugs work in the short-term to relieve psychotic symptoms but long-term guarantee what might be a recoverable disease will be guaranteed to be chronic and debilitating. The main proponent, as far as I know, of this is Mad In America

I’m still learning, so I don’t know what to think! One would think that science would have settled the question and if anyone can post links to scientific papers about the pros and cons of medication, I’d appreciate it.

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In our son’s case this last time it took longer to have him stabilized, and unfortunately it didn’t take long either to stop taking the meds again; without the meds it has taken very little time to have the positive symptoms back: hallucinations, lack of sleep and the paranoia, the feeling that he’s being followed by his father, he’s withdrawn and keeping to himself, sometimes he’s ‘calling heaven for help’, since we’ve seen this pattern before I didn’t wait for it to escalate and called the Care Line and he was taken to the hospital but he’s still upset that I asked for help. It’s great hat we’re heading into Summer because in the Fall and Winter he wanders around without proper protection of the cold weather and he has gotten frostbite on his toes and thumb already. In here the temperature last Winter dropped some days in the minus.
He might never get it.

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This is a tough one. I am all for holistic healing and less medication. But, in a situation such as schizophrenia, I believe medication is necessary. I took my son to a leading medical treatment center (UCSF). He was treated by the head of the program as an outpatient. I was told that in order for him to have any chance of healing to a somewhat normal life, he would have to be medication compliant for a minimum of 5 years, and then stay on the medication. But it would take at least 5 years to truly stabilize him. He has been living in a residential treatment facility for 18 months now, and I see a huge difference, but he still has a long way to go.
Give yourself the goal of 5 consecutive years of medication compliance, it is important

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There’s a recent Danish study of about 500 people with SZ that claims 30% of about 300 respondents manage to avoid psychosis without medication after 10 years. Those who function better tend to be female and are employed.

At first glance, I see flaws in the study. Approximately 200 people were dropped from of the study due to lack of response over the decade of study. That would mean approximately 90 out of an initial 500 are known to avoid relapse, so I would put that number closer to 18% than 30% in my eyes. I’d heard that 10-15% of people with SZ “spontaneously remit” for the past 35 years of my diagnosis, so there may be some credence to the lower number. The study appears to be of participants who had at least some drug treatment, but may have ceased treatment. Lower dosages or cessation of medication seemed associated with better prognosis for these people, however I think there’s the possibility of “cherry picking” of milder cases or possibly misdiagnoses in the study.

I’d also argue that employment is a form of therapy, so I don’t think it fits the OP’s definition of untreated.

Do I think that a minority of people with SZ recover to a point they don’t need medication? Yes. I believe I could probably stay off medication and still avoid psychosis. However, do I recommend no treatment at all? No. There’s a difference between avoiding psychosis and living a full life, and there are alternate therapies that can complement or supplant medication. I feel there’s an over reliance on medication, especially as a mono therapy, and dosages tend to be overly conservative, but judicious use of medication is a useful tool that can supplement other treatments.

Here’s a link to information about that Danish study:

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I looked at the title and it says " first-episode psychosis". I can’t see the full article from the link, but apparently it’s about newly-diagnosed people.

If a family jumps on it right away after the first episode with meds and recovery-model approaches such as peer groups, CBT, vocational support, social training support, etc. I think the outcome is definitely improved.

My wife and I did none of this. We just hoped my son could see a shrink, get some meds, and he’d get better. We had no idea what we were dealing with.

Belatedly, I’ve been clued into the Recovery Model of Mental Illness: A Complementary Approach to Psychiatric Care and am now trying to figure out how to find resources and motivate my son.

Almost everyone, I think, believes that drugs have their place but you can’t rely on them as the sole treatment for the disease. Ideally, the minimum effective dose needs to be found and non-drug approaches need to be ramped up.

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Does medication do more harm than good? How I wish we knew the answer. My son has been virtually unmedicated for 10 years of suffering. Can’t say as we’re doing all that well, but I have heard way worse situations than ours.

I would think that there would be so many complicating factors in trying to detangle this in a scientific fashion. For one thing it would be very difficult to establish a pool of unmedicated subjects and maintain contact with them since they are not “in the system”. Also these people are more than likely the ones who have suffered the most - many have spent their entire adult lives on the street (and in jail), which is enough to destroy the mental health of even the strongest, confounding the issue.

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All good points on you all.
I can’t help but also consider the test group itself and if I’m reading it correctly it’s from ‘07?
How much have we learned since and if these were diagnosed schizophrenic, what type? Am I correct in understanding that just in the last few years this idea of basic sub-types structure has itself been reconstructed? It seems to me we’ve been seeing an influx of contributors in this site alone amongst family and caregivers where loved ones are getting diagnosed with a one-off psychotic episode. Is this standard now for diagnostic procedure? I remember just 10 years ago that it was standard to take a long while of observation over an ongoing period and hash through multiple other potential diagnosis for exhibited symptoms to fully determine a schizophrenic diagnosis. Often over a period of no less than a couple years. Thus, I question the study group and their credible ‘diagnosis’ first. Since, as we all know, it appears every case presents significantly different both in form and intensity. Duration since onset? Another factor. As far as the efficacy of antipsychotic meds, either first or second generation, we KNOW the side effects are often brutal and all can be detrimental to the body over extended durations. How are we gauging the efficacy in this particular group? As in, are we looking at a specific and common symptom to all subjects, and working on the assumption they’re all of the same initial level of functioning? What’s the baseline for ‘standard’ neurological functioning, and if so, what is it? Neuro imaging? IS there one presented even? Given the duration of the study, I find myself in the end, again, not questioning wether the meds work or not, are necessary for long term prevention or not, but wether the diagnostic system is sound or not.
Yes, in my humble opinion also, mental illness is an entirely complicated area of study, and difficult to observe in full with all contributing factors in consideration.

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