5 Thoughts on Schizophrenia Medication Reduction

Patient Expert

A recent study indicated that lowering the dose of risperidone or olanzapine in schizophrenia patients 50 years old or older can be effective as a measure to try to ward off extrapyramidal symptoms or other symptoms like weight gain.

One caveat: the follow-up was three to six months after the study. In that time frame most of the participants did not experience clinical deterioration.

My five thoughts on this latest news:

Lower doses of medication that are effective should be tried where clinically possible.

Stories from community members at HealthCentral and other research indicates peers have had success with lowering their medication. In a 10-year Johns Hopkins study, lead researcher Bernadette A. Cullen, M.B., B.Ch, B.A.O, MRCPsych, understood: "You rarely need to be on extremely high doses."

Early death is not the inevitable outcome of taking appropriate doses of schizophrenia medication.

The risk of death in the Johns Hopkins study was 25 percent lower for those patients who had 90 percent or better compliance with their medication compared to those who were less than 10 percent compliant.

Cullen believes that if people are taking their medications, "they usually have fewer symptoms and are more likely to make appointments with their primary care doctors, to stay on top of other illnesses they may have and to regularly
take diabetes, blood pressure or cholesterol medication...they are more likely to...have a healthier lifestyle."

Treatment should not and cannot be one-size-fits-all.

We cannot fall into the trap of thinking "no one should take medication at any time." Sure, some individuals might not need medication yet others wouldn't be able to function without it. And not all medication is created equal.

The treatment provider (psychiatrist, nurse practioner or physician's assistant) should welcome a dialogue with their patients. As educated individuals, we can start with the top 10 questions to ask our doctor. Alternatives to
weight-gaining medication exist, like Geodon and Latuda that are thought to be less likely to pack on the pounds.

The automatic response of our providers to try us on risperidone or olanzapine first, instead of another drug, shouldn't be the only option considered for a person who has experienced a first episode if you ask me.

Effective treatment requires using multiple approaches.

Unlike StyleWatch magazine's "one-and-done" feature for women's makeup it can't be "one-and-done" for schizophrenia treatment. Simply only popping pills alone won't get a person to recovery.

As I reported in a recent SharePost, three healthy recovery habits contributed to my success and might help others.

Lloyd I. Sederer, MD, in his June 23, 2015 news article in Huffington Post online, is quoted:

“Skill building in social and work areas, combined with cognitive techniques to manage paranoia, combined with medications, combined with family education and support, combined with outreach to help people stay engaged are more effective than any one approach alone.”

Early psychosis intervention often allows the person to take a lower dose of medication.

Programs for treating schizophrenia in prodromal stage can halt disability without maintenance medication for a minority of people, like Tiffany Martinez who utilized the PIER program in Maine. My positive schizophrenia prodromal
experience
and subsequent early intervention to halt symptoms helped me be able to take a low maintenance dose.

For 16 years I took only 5 mg of Stelazine, a traditional neuroleptic. For four years after that I took 10 mg. One person in the audience at a talk I gave was astounded when I told him this. Then he asked the drug I was taking now because I hadn't gained any weight on it. Right now I'm at the upper limit of that dosage which I'm okay with because I've been in remission 23 years now.

Related SharePosts on schizophrenia treatment:

Three positive thoughts on 10-year recovery outcomes
Three tactics for schizophrenia treatment for you or your loved one