September 7, 2006

Stopping Meds Does Not Cause Relapse

Glick and friends did a  small study finding-- big surprise-- stopping some of the medications when a schizophrenic is stable does not drive them into a horrible suicidal relapse.  Some even got better.


Naturalistic study: 53 stable schizophrenics on antipsychotics were tapered off of antidepressants or mood stabilizers and followed for up to two years, using CGI as the measure (sigh.)

20/21 patients tapered off antidepressants were unchanged or (n=3) better; the one who did worse was an 18 yo WM on 300mg Wellbutrin.

9/12 tapered off mood stabilizers were unchanged; the three who did worse were all WM (actually, they were all white) on Lithium 600, Tegretol 1200, or Neurontin 1200. 


So while that is very encouraging though only preliminary, what got me about the paper was this sentence:


"There are definitivew data in general medicine showing that combintations are much more effective than monotherapy, supported by many randomized blinded studies with a good understanding of mechanism--" 

 Seriously?  Does he have access to some other internet than I have?  What are the references?


"-- in chronic pain, for example.16"


Oh, chronic pain.  I see.


FYI: Glick also did a study on suicidality, finding that the study that showed Clozaril's anti-suicide property (InterSePT) had nothing to do with the concomitant medications (mood stabilziers, antidepressants or benzos). 



(16) references a morphine  +/- neurontin for pain paper. 


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