New York—Antipsychotic medications have gotten some bad press in recent years, and a new study said the drugs’ generally unjustified bad reputation has caused some patients or their families to refuse treatment.

Noting that nearly seven million Americans take antipsychotic medications for the treatment of schizophrenia and related conditions, the article in American Journal of Psychiatry reports on the results of a comprehensive examination of studies on patient outcomes and, more specifically, clinical outcomes of patients and changes in brain structure with antipsychotic therapy.

Their conclusion? Antipsychotic medications do not have negative long-term effects either on outcomes or on the brain for patients with schizophrenia and related psychotic disorders. Furthermore, the reviewers emphasize that the benefits of the therapy substantially outweigh risks of adverse effects.

“The evidence from randomized clinical trials and neuroimaging studies overwhelmingly suggests that the majority of patients with schizophrenia benefit from antipsychotic treatment, both in the initial presentation of the disease and for longer-term maintenance to prevent relapse,” explained Jeffrey Lieberman, MD, Lawrence C. Kolb Professor and Chairman of Psychiatry at Columbia University College of Physicians and Surgeons and Director of the New York State Psychiatric Institute. “Anyone who doubts this conclusion should talk with people whose symptoms have been relieved by treatment and literally given back their lives.”

Lieberman worked with an international team involving researchers from the United States, Germany, The Netherlands, Austria, Japan, and China.

Conversely, delaying or withholding treatment has a proven association with unsatisfactory long-term outcomes.

“While a minority of patients who recover from an initial psychotic episode may maintain their remission without antipsychotic treatment, there is currently no clinical biomarker to identify them, and it is a very small number of patients who may fall into this subgroup,” Lieberman said. “Consequently, withholding treatment could be detrimental for most patients with schizophrenia.”

Study authors point out that treatment discontinuation or alternative nonpharmacologic treatment approaches might be associated with incremental risk of relapse and require further study, including the development of biomarkers that will enable a precision medicine approach to individualized treatment.

“While more research is needed to address these questions, the strong evidence supporting the benefits of antipsychotic medications should be made clear to patients and their families, while at the same time they should be used judiciously,” Lieberman added.

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