Negative Evidence to the Longitudinal Usage of Antipsychotics

October 31, 2017
Anna Jankowska, LCPC

By Anna Jankowska, MA, CEAP, SAP, LCPC

Anna Jankowska is a mental health, addiction, and substance abuse counselor with over 17 years of experience and has specialized training and skill in working with individuals, groups and communities to improve mental health outcomes. NPI number: 1598843526

Like science, society continues to grow, expand our thinking, and come up with new ways to improve life around us all. However, like science, sometimes we are unsure if the new ideas, growth and “improvements” are always best for everyone. An article done by Bernalyn Rulz called, Patients with Schizophrenia Show Better Work Functioning Off Antipsychotics, talks about a study done on patients with schizophrenia who were not prescribed antipsychotics over a many year time period.

The study consisted of 139 initially psychotic patients who researchers followed and studied for over 20 years. The article explains how patients not prescribed with antipsychotics has significantly better work functioning in the future then those who were described. Although patients were initially prescribed during acute hospitalization and initially benefited from it, the study proved negative on the long term efficacy of antipsychotics.

Another element the article and study point out is how previous research had a lack of evidence on the effectiveness of antipsychotic drugs after 3 years of use. In other words, while there may be prescribed patients and tangible evidence of the benefits of this antipsychotics, after 3 years, the effects diminish and a patient is even better off without the prescribed antipsychotics.

During the 20-year time period, there were 6 follow ups with the patients in order to examine the longitudinal effects of going off the antipsychotic drugs in comparison to those who stayed on them. The article states: “At each of the remaining time points, the un-medicated group performed significantly better on work functioning. From the 4.5-year assessment on, over 65% of patients not on antipsychotics were working half-time or more.” As a follow up to the results given, the article goes on to explain how patients who were continuously prescribed with antipsychotic medications were significantly more likely to have negative symptoms and less likely to be working at the 4 to 6 follow up periods. Even when it came to controlling for premorbid achievements, the author explains, “those with poor premorbid achievements not on antipsychotics had significantly better work functioning then those prescribed antipsychotics who also had premorbid developmental achievement (Rulz).

Overall, the results of this study goes to show the negative impacts antipsychotics have on patients with schizophrenia after 2-3 years of usage. It continues to add to the ongoing and ever-growing discussion and conclusion that antipsychotics demonstrate a lack of long-term positive effects. Furthermore, the article reports a higher rate of recovery for those off antipsychotics. The authors who did the actual study wrtire: “The data indicate that any hypothesis based on the view that antipsychotics facilitate work functioning are extremely doubtful since the results for work functioning were running strongly (at significant levels) in the opposite direction.

With this in mind, I found it interesting to think about what studies have been done and if they say anything about the long-term use of antipsychotics and those who have bipolar disorder. Furthermore, can there be and conclusion drawn from medication across the board? Understanding one’s own view when it comes to prescribing clients is of the utmost importance, something that will shape the rest of one’s career no matter the direction. One to be wary of in the field of Psychology.

Harrow, M., Jobe, T. H., Faull, R. N., & Yang, J. (2017). A 20-Year multi-followup longitudinal study assessing whether antipsychotic medications contribute to work functioning in schizophrenia. Psychiatry Research256, 267-274.

Related Posts


Submit a Comment

Your email address will not be published. Required fields are marked *