A government-funded study found that one-on-one talk therapy coupled with lower doses of antipsychotic medication may be a more effective intervention for schizophrenia than relying on drugs alone.
Results from the Recovery After an Initial Schizophrenia Episode (RAISE) study, published Tuesday in the American Journal of Psychiatry and spearheaded by the National Institute of Mental Health (NIMH), suggested this new mode of treatment that could lower use of antipsychotics by up to 50 percent.
Following 404 schizophrenia patients, the study offered traditional antipsychotic drug treatment to half, and 50 percent lower amount of drugs to the other half but with a triple social support technique that involved schools, families, and talk therapists.
Schizophrenics who gained the most benefit from talk therapy, too, comprised patients whose first psychotic episodes occurred in their early 20s.
RAISE, launched by NIMH in 2008, is a large-scale research analyzing coordinated specialty care (CSC) for those who are experiencing first-episode psychosis, focusing on the effectiveness of treatment.
CSC provides treatments such as psychotherapy, medication management, and family education and support as a personal treatment plan.
Antipsychotics, while they can blunt schizophrenia symptoms such as hallucinations and delusions, have been linked to side effects that include drowsiness, tremors, severe weight gain, and difficulty handling emotions. The side effects are believed to push about three-fourths of patients to drop medication within 1.5 years.
The Centers for Medicare and Medicaid Services incorporated the report findings into its new recommendations released last Friday, advising a combination of talk therapy and medication for patients of this mental health condition.
Talk therapy is poised to help improve patients' and their families' quality of life. In 2014, the United States Congress allocated $25 million in state grants for early-intervention initiatives emphasizing a mix of therapy and drugs, with 32 states now on board.
Vinod Srihari, psychiatry associate professor at the Yale School of Medicine, said the U.S. is "really a decade behind the rest of the world" in practicing this kind of coordinate care for patients. "[A]nd the outcomes are good," he said.
Robert Heinssen, NIMH services and intervention research director, highlighted the key finding of the study: doing the right thing at the right time.
"That is guiding our efforts going forward. That has become the north star of where we're going."
Photo: Alden Chadwick | Flickr
