The dose required to treat first-episode patients with SZ is generally about half that prescribed when the illness becomes chronic. First and second generation antipsychotics were seen as nearly equally effective in studies, though drop-out rates were high in the CATIE Study as well as EUFEST [the European First Episode Schizophrenia Trial].
Indeed, "Continued medication adherence is far and away the strongest clinical predictor of sustained remission and stability, yet only 25 percent of first-episode patients will continue to take an antipsychotic consistently for one year after starting treatment." Almost all eventually stop their medication.
Anosognosia, the lack of insight, is in effect: More than 50 percent of first-episode patients will deny they have an illness once their initial psychosis subsides. A great number stop taking their medications.
It's clear to me I was on "the lucky end of the luck of the draw": After I was diagnosed, I took my medication as prescribed, every single day for four years. As I stated in the intro to this article, I will go to my grave championing early intervention. Along with the right meds, psychosocial treatments are instrumental. I attended a day program for two years, had weekly one-on-one sessions with a therapist, and OVR-the Office of Vocational Rehabilitation-sent me for training as a word processor so I could get my first job as an administrative assistant.
I'm not proud that I was one of the lucky ones. I offer my life, talents and experiences to others in the hopes that they will be encouraged to get help as soon as possible to avoid long-term disability. It's not my intention to be a prophet of doom and gloom by referring to the Harvard Mental Health Letter. Rather, it's the first step I'm compelled to take in reaching out to the general public: those not intimately affected yet [and hopefully not ever] by schizophrenia. Preaching to the choir isn't my intent [I sing off-key]. I feel it's imperative to come down from the choir loft and mingle with every day people living in the world, to show by our humanity and our humanness that we must carry each other across the threshold of hope that a person can recover.
The reality is, there are people for whom recovery is that much harder because of the delay in treatment-and it is my mission to halt that trend. The one barrier-stigma-I have overcome because I decided to be open and honest about what happened to me. I'm willing to risk rejection, I'm willing to stand alone in fighting for what I believe in: the right of every person diagnosed with SZ to recover to the best of their ability, and to be treated with dignity by those of us who will not ever be tormented by this medical condition.
Like any other disease, like cancer or stroke, early intervention is the best chance for recovery. If you had lung cancer, you wouldn't forgo chemo until it was too late. If you had a stroke, you'd call 911 immediately. I rest my case.