Long term use of antipsychotic medication.

Long term use of antipsychotic medication is one of the challenging contemporary discussions  in our field.

The "traditional" idea, supported by "traditional research" that this pharmacological strategy provides stability by reducing relapse rates, in now challenged by other kind of research that poses that, considered under the "recovery perspective" - i.e, to live a life that deserves to be lived, quoting the Spanish philosopher Adela Cortina- and considering long term side effects, strategies that recommend discontinuing use of drugs, should be considered since they might me more advisable or eligible.

Nowadays, this topic is dealt in many different ways, and gathers a lot of attention in the media. Different authors consider different perspectives. Some (see Robert Whitaker, David Healy, Peter Gøtzsche) claim in different ways that the behavior of the pharma industry has not been correct -to say it politely- when disseminating biased information about the many pros and few cons of pharmaceutical drugs. Some stakeholders from the side of people with living experience write about how to get rid of pills (e.g. Peter Lehman), often disregarding the possibility that they may be useful in some way for some persons at some moments. Even in a strictly clinical perspective, to consider these perspectives (por example, stabilityvs. meaningful life), leads to highly complex scenarios, where many different factors need to be carefully weighted in considering what is he best advise we can offer our patients. (Not forgetting the many other considerations to be included: the most obvious, the right to choose of the person, and the ban of forced treatments derived from a strict interpretation of the CRPD).

In Madrid 2018 we plan to contribute for the best possible discussion of this crucial topic. Following the principle that "research is better that rhetoric", we have decided to invite Joanna Moncrieff, who has been a very visible and active part of this discussion in the last years. She is also connected with a research group on the topic. We are very glad to announce that she was kindly accepted our invitation and will take part of in the Conference.



This is the note she has sent us as abstract for her lecture. Many thanks to her for allowing us to add it to our blog.

"The Bitterest Pills: considering the pros and cons of long-term antipsychotic treatment"
Antipsychotic drugs have been proclaimed as miracle cures, but are hated by many users. However, long-term antipsychotic treatment remains the usual treatment for most people with psychosis or schizophrenia. The proposed talk will explore ideas about how antipsychotics exert their effects and present data on the nature of the mental and behavioural alterations they produce. It will look at evidence for the benefits and harms of long-term antipsychotic treatment and describe the design and progress of a trial comparing a gradual programme of antipsychotic reduction and discontinuation with maintenance treatment. Finally, the talk will consider how to help clinicians and patients to approach the use of antipsychotics in different situations.