"Are there any doctors out there with a shred of decency left who might maybe think twice about prescribing these drugs to their patients?"

I haven't found one yet. er, let me rephrase that: my daughter hasn't found one in the adult mental health medicaid paid system yet.

Expecting doctors to question the only treatment they've known? HAH. This day will never happen.

I'd love to see ONE doctor, and I've been in the loop a hella long time, EVER discharge a patient OFF of any antipsychotic. BUT I sure have gotten to know many patients in a revolving door on meds/off meds loop in hospitals.

It makes one question a lot when, as a parent I start to know by first name basis clients/patients inside/outside of hospitals and care facilities. It's one big happy family. Well the happy part is questionable. It's extremely sad. To make that clear: I see the same people over and over again inside psych wards and outside. If the doctor's treatments were working this wouldnt be happening. Over a 2 year period of time, I've seen far too many of the same faces in hospitals and in out patient settings remain on the revolving door hinged on a paradigm that is proving itself to fail, every single day. Some people die as a result of this treatment paradigm being unquestioned by doctors.

Age comes with some patients, and the newer generation, like my daughter, are entering the same worn out treatment program. It's not good news.

Not trying to pimp my own blog, but I wrote a post--paliperidone palmitate : hope for schizophrenia? or the new DSM?" that has a sickening and scary long list of how this possible new SZ drug could cover just about everything possible in the DSM. (its a metabolite of Risperdal as reported here before).

One of the links I have in that post looks like this: (I'm sure this covers the new DSM quite well, and shows the possible broad use of antipsychotics in the future. Social anxiety is in there, as are many other benign DX's.[or basically human conditions not needing medication].

7. The method of claim 1 wherein the psychiatric patient has a mental disorder or mental illness selected from the group consisting of Mild Mental Retardation (317), Moderate Mental Retardation (318.0), Severe Mental Retardation (318.1), Profound Mental Retardation (318.2), Mental Retardation Severity Unspecified (319), Autistic Disorders (299.00), Rett's Disorder (299.80), Childhood Disintegrative Disorders (299.10), Asperger's Disorder (299.80), Pervasive Developmental Disorder Not Otherwise Specified (299.80), Attention-Deficit/Hyperactivity Disorder Combined Type (314.01), Attention-Deficit/Hyperactivity Disorder Predominately Inattentive Type (314.00), Attention-Deficit/Hyperactivity Disorder Predominately Hyperactive-Impulsive Type (314.01), Attention-Deficit/Hyperactivity Disorder NOS (314.9) Conduct Disorder (Childhood-Onset and Adolescent Type 312.8) Oppositional Defiant Disorder (313.81), Disruptive Behavior Disorder Not Otherwise Specified (312.9), Solitary Aggressive Type (312.00), Conduct Disorder, Undifferentiated Type (312.90), Tourette's Disorder (307.23), Chronic Motor Or Vocal Tic Disorder (307.22), Transient Tic Disorder (307.21), Tic Disorder NOS (307.20), Alcohol Intoxication Delirium (291.0), Alcohol Withdrawal Delirium (291.0), Alcohol-Induced Persisting Dementia (291.2), Alcohol-Induced Psychotic Disorder with Delusions (291.5), Alcohol-Induced Psychotic Disorder with Hallucinations (291.3), Amphetamine or Similarly Acting Sympathomimetic Intoxication (292.89), Amphetamine or Similarly Acting Sympathomimetic Delirium (292.81), Amphetamine or Similarly Acting Sympathomimetic Induced Psychotic with Delusional (292.11), Amphetamine or Similarly Acting Sympathomimetic Induced Psychotic with Hallucinations (292.12), Cannabis-Induced Psychotic Disorder with Delusions (292.11), Cannabis-Induced Psychotic Disorder with Hallucinations (292.12), Cocaine Intoxication (292.89), Cocaine Intoxication Delirium (292.81), Cocaine-Induced Psychotic Disorder with Delusions (292.11), Cocaine-Induced Psychotic Disorder with Hallucinations (292.12), Halluciogen Intoxication (292.89), Hallucinogen Intoxication Delirium (292.81), Hallucinogen-Induced Psychotic disorder with Delusions (292.11), Hallucinogen-Induced Psychotic disorder with Delusions (292.12), Hallucinogen-Induced Mood Disorder (292.84), Hallucinogen-Induced Anxiety Disorder (292.89), Hallucinogen-Related Disorder Not Otherwise Specified (292.9), Inhalant Intoxication (292.89), Inhalant Intoxication Delirium (292.81), Inhalant-Induced Persisting Dementia (292.82), Inhalant-Induced Psychotic Disorder with Delusions (292.11), Inhalant-Induced Psychotic with Hallucinations (292.12), Inhalant-Induced Mood Disorder (292.89), Inhalant-Induced Anxiety Disorder (292.89), Inhalant-Related Disorder Not Otherwise Specified (292.9), Opioid Intoxication Delirium (292.81), Opioid-Induced Psychotic Disorder with Delusions (292.11), Opioid Intoxication Delirium (292.81), Opioid-Induced Psychotic Disorder with Hallucinations (292.12), Opioid-Induced Mood Disorder (292.84), Phencyclidine (PCP) or Similarly Acting Arylcyclohexylamine Intoxication (292.89), Phencyclidine (PCP) or Similarly Acting Arylcyclohexylamine Intoxication Delirium (292.81), Phencyclidine (PCP) or Similarly Acting Arylcyclohexylamine Induced Psychotic Disorder with Delusions (292.11), Phencyclidine (PCP) or Similarly Acting Arylcyclohexylamine Induced Psychotic Disorder with Hallucinations (292.12), Phencyclidine (PCP) or Similarly Acting Arylcyclohexylamine Mood Disorder (292.84), Phencyclidine (PCP) or Similarly Acting Arylcyclohexylamine Induced Anxiety Disorder (292.89), Phencyclidine (PCP) or Similarly Acting Arylcyclohexylamine Related Disorder Not Otherwise Specified (292.9), Sedative, Hypnotic or Anxiolytic Intoxication (292.89), Sedation, Hypnotic or Anxiolytic Intoxication Delirium (292.81), Sedation, Hypnotic or Anxiolytic Withdrawal Delirium (292.81), Sedation, Hypnotic or Anxiolytic Induced Persisting Dementia (292.82), Sedation, Hypnotic or Anxiolytic-Induced Psychotic Disorder with Delusions (292.11), Sedation, Hypnotic or Anxiolytic-Induced Psychotic Disorder with Hallucinations (292.12), Sedation, Hypnotic or Anxiolytic-Induced Mood Disorder (292.84), Sedation, Hypnotic or Anxiolytic-Induced Anxiety Disorder (292.89), Other (or Unknown) Substance Intoxication (292.89), Other (or Unknown) Substance-Induced Delirium (292.81), Other (or Unknown) Substance-Induced Persisting Dementia (292.82), Other (or Unknown) Substance-Induced Psychotic Disorder with Delusions (292.11), Other (or Unknown) Substance-Induced Psychotic Disorder with Hallucinations (292.12), Other (or Unknown) Substance-Induced Mood Disorder (292.84), Other (or Unknown) Substance-Induced Anxiety Disorder (292.89), Other (or Unknown) Substance Disorder Not Otherwise Specified (292.9), Obsessive Compulsive Disorder (300.3), Post-traumatic Stress Disorder (309.81), Generalized Anxiety Disorder (300.02), Anxiety Disorder Not Otherwise Specified (300.00), Body Dysmorphic Disorder (300.7), Hypochondriasis (or Hypochondriacal Neurosis) (300.7), Somatization Disorder (300.81), Undifferentiated Somatoform Disorder (300.81), Somatoform Disorder Not Otherwise Specified (300.81), Intermittent Explosive Disorder (312.34), Kleptomania (312.32), Pathological Gambling (312.31), Pyromania (312.33), Trichotillomania (312.39), and Impulse Control Disorder NOS (312.30), Schizophrenia, Paranoid Type, (295.30), Schizophrenia, Disorganized (295.10), Schizophrenia, Catatonic Type, (295.20), Schizophrenia, Undifferentiated Type (295.90), Schizophrenia, Residual Type (295.60), Schizophreniform Disorder (295.40), Schizoaffective Disorder (295.70), Delusional Disorder (297.1), Brief Psychotic Disorder (298.8), Shared Psychotic Disorder (297.3), Psychotic Disorder Due to a General Medical Condition with Delusions (293.81), Psychotic Disorder Due to a General Medical Condition with Hallucinations (293.82), Psychotic Disorders Not Otherwise Specified (298.9), Major Depression, Single Episode, Severe, without Psychotic Features (296.23), Major Depression, Recurrent, Severe, without Psychotic Features (296.33), Bipolar Disorder, Mixed, Severe, without Psychotic Features (296.63), Bipolar Disorder, Mixed, Severe, with Psychotic Features (296.64), Bipolar Disorder, Manic, Severe, without Psychotic Features (296.43), Bipolar Disorder, Manic, Severe, with Psychotic Features (296.44), Bipolar Disorder, Depressed, Severe, without Psychotic Features (296.53), Bipolar Disorder, Depressed, Severe, with Psychotic Features (296.54), Bipolar II Disorder (296.89), Bipolar Disorder Not Otherwise Specified (296.80), Personality Disorders, Paranoid (301.0), Personality Disorders, Schizoid (301.20), Personality Disorders, Schizotypal (301.22), Personality Disorders, Antisocial (301.7), and Personality Disorders, and Borderline (301.83).

Obviously I haven't seen the study either but anytime they start comparing drugs for effectiveness and discontinuation effects I sure want to know what the prior medication histories of the patients are and how the "wash out" (leading into the study) was designed. Unless there's a lot of detail about this the studies are essentially meaningless since withdrawal from prior treatments can be confounding everything. If it truly is first episode psychosis and (it's not drug induced psychosis) then there is a chance these patients are more drug naive than might be typical in most studies involving schizophrenic and psychotic patients, but the fact is there still could be a long history of medication use (or substance abuse) that should be accounted for before conclusions are drawn. Remember withdrawal is routinely ignored and dismissed by academic clinicians trying to run trial studies.

And 60% success rate? Over what period of time, please? Just a few weeks or something a lot longer. The best long term success (i.e. actual cure) rates in schizophrenia as I understand it are in people who have little medication. Admittedly there are people who "control symptoms" reasonably well on long term medication but usually they aren't functioning at a high level nor can they honestly be termed "healed".

Switching from schizophrenia to bipolar for a sec (aka going off topic a bit) I was just directed by another blogsite to your 2/1/07 piece of investigative journalism showing how Lilly launched the campaign to use Zyprexa on an ongoing basisfor individuals with bipolar. The head of this effort is now to become head of the APA despite all his slimy conflicts of interest with Pharma. I am not turning into a Scientologist but am joining them as I read of this money grubbing and people killing into a position of despising the profession. Why don't they just buy a gumball machine and put it beside the front door of their office. Put your silver dollars in and out comes the drug of choice. This way they can just stay home in bed.

60% of the people my daughter live with take Clozaril; and all of these people reside there instead of the state institution locked up. I guess there's a side of the "risk outweighs the benefit" that we often don't see when people use antipsychotics. In this case, thank God they are all free from locked up walls of hell. It's a really bad thing, then it's a good thing when ppl like me have played basketball as a visitor on the courts of the locked state hospital; vs. an unlocked care facility where people have a better life than locked up. Quality of life sometimes comes at a price, and one will never know in this case how many could go off of meds. I'm hoping my daughter's age is a plus for her in that respect; and then it's her own self-determination that will get her where some people claim to be "healed" or "recovered" off of meds. One common age I've observed in the last 2 years, is by 45-50 most severe SZ patients either give up, give in and remain on meds just functioning at basic care level; and I hate to break it to everyone, but they won't be off of meds, but they made it out of the lock up.
This is where we need to expand horizons and get more than step-down care facilities, and add Soteria settings. Because we know the dangers of these meds, and there are no other treatments in current medical model for typical psychiatrists to use. Nothing. So then the question becomes, for myself as one who sees many people every day in a situation medicated non-locked up--what got them there? age? the burn out of aggression? the complete loss of human spirit hammered down by years [decades] of antipsychotic use? The next generation, which includes my daughter deserves the current paradigm be challenged, so she doesn't end up old and sitting in a chair all day.Stuck in a system that promotes antipsychotics as the only hope. The people who are in their 60's, 70's, well it's been a long road for them, and I'm grateful they are not locked up so they can continue to feel freedom, though the price they've paid goes without saying, was a great one at the expense of spirit and soul.

Actually, the study includes some interesting data: only 1/3 of the surveyed providers believed that atypicals were better than first generation antipsychotics; 2/3 thought that first-generations were no worse than atypicals. That's an important bit of evidence.

Sorrowful, i've addressed you comments from the other post in the other post, the one about 'Is america really so sick' I suggest you go and read it...

On this post, I would say the following...

A drug that addresses psychotic symptoms? Bullshit. Simply that. I can address your depression by murdering you, and I shut down every element of your human experience. A drug can address your depression by hindering and reducing your feeling of the entire human experience by hindering the higher function of your brain, in a blanket way.... Is that an ideal scene?

It's all bullshit... and if any biopsych drug targets symptoms with and kind of efficiency without hindering higher function in every way, i'll shut up. But it doesn't exist.

Every extrapolation of thorazine, read every psych drug, is nothing but a variant on the chemical straight jacket. Any 'specificity' you believe it has, is just that, a belief, a complete faith based ideology....backed by big PR and big pharma, and you're going around in circles...

If I were emperor, psychs would be first against the wall, the books burned, and we'd all sleep well.

And scientology is just a red herring, stop giving it oxygen, listen to the meek qualifications any critic thinks they have to make...its pathetic...."im not a scientologist, but...." ooohhh give me break, if that's what secualar psychiatry criticism has degenerated to, I'm out of here.... I mean the future of activism is bleak if we all have to qualify each statement with a scientology renunciation.... come on!!!!!

Think of scientology thus: a christian evangelism mission seeks donation for water wells in africa, because its an injustice they want righted....scientology, sees injustice with biopsych, and they want it righted.....does that mean that the secular world can't donate water wells, and can't want to destroy psychiatry?

Red herring all the way. My god. My xenu.

Jesus.

Sorry Bill. I have never mentioned the word "scientology" here or anywhere before. I'm sorry but I don't understand what you are trying to say. I can't imagine the situation I am in, with my son killed, but I also can't imagine the situation Stephany is in, having to deal with drugs that rob you soul in a system that does the same thing.

I am one of those unfortunately diagnosed schizophrenics who was hoodwinked by my psychiatrist into thinking that the atypical antipsychotics were the appropriate first line of defense in my arsenal against the symptoms of schizophrenia. After four years and much weight gain, the medication (I took many different atypicals) achieved bloody NOTHING. I continued to hear voices despite the disabling side-effects of these drugs.

Fortunately, during my time on the atypicals, I made the decision to work with my voices and try to ameliorate the situation. My ultimate objective was to align "our" interests (i.e. live and thrive) and become genial inhabitants of the same mind.
Much to my joy (and relief), this came to pass. My voices, Sam & Program, have evolved from negative to neutral, and from neutral to loving and supportive.

After more than three years of harmonious cohabitation, I decided to try to go off the antipsychotic (I was also terrified of Type II diabetes). Fortunately, I found a psychiatrist who supported me in this decision. Now, nine months later, I've lost 50 lbs. of the 80 lbs. I gained, and my cholesterol and triglycerides have dropped from dangerous to normal levels. Moreover, I no longer sleep fourteen hours a day. I continue to be an unusual case in that I'm completely functional, yet still clinically symptomatic. My progress is such, though, that I'm trying to gain admittance into the Stanford University computer science master's program.

In summation, I sincerely hope to become a champion of including the therapeutic strategy of working with the positive symptoms of schizophrenia in lieu of simply masking them; whereas masking them requires powerful, and often dangerous, pharmaceuticals. I would never advocate abandonment of the psychiatric model, only that they take a more inclusionist stance on new therapeutic strategies.

I'm on Seroquel right now, and I don't feel like it works as well as what I've been on in the past.

I am fascinated by Lori's comment and wish more people who have learned to live in harmony with their voices would describe their experiences. I remember the first time I heard about the Hearing Voices Network in Britain it just blew me out of the water -- it touched a chord with me and made a lot of sense. To me it is so true that we need to work respectfully with these symptoms and not panic in their presence and not medicate them to oblivion while destroying the body and spirit in so many other ways at the same time.

Sara, one of my readers has directed me to the Hearing Voices network; and I hope one day my daughter can use something like this too.

Lori, your comment is beautiful. Good Luck.