For patients who have had a first episode of psychosis (hallucinations, paranoia, mental disorganization, delusions), there has been some controversy about whether to stop the medicine after one year has elapsed.The thinking was this: How will we know if the psychosis was just a one-time event and now they don’t the medication any more? Indeed this is a question that many patients themselves pose — and often answer themselves without the input of specialist. Well some new data was just released examining what would happen if a group of first-episode patients were switched to placebo after at least one year of treatment. Here’s what the researchers found out: across the board, no matter how they crunched the numbers, the risk of relapse into psychosis was doubled for the placebo group. In some cases this meant that 56% of the patients on placebo relapsed, but in other cases this meant that 79% of the patients on placebo relapsed (depending on how they defined the criteria). These are some pretty significant numbers.
The bottom line here is that, for patients with psychosis, going off one’s meds is risky business. There are other mental health conditions for which we have much better outcomes with medication discontinuation, but it looks like psychosis is not one of them. So if you or someone you know is thinking about stopping medication, talk to a specialist and consider doing it in an inpatient setting where a relapse can be quickly and expertly handled.