Dr. X asked Ian and me after Chris had been under his care for three weeks, what our thinking was as to why Chris was improved. "It's easy, we said, "he's away from us!" It was getting absolutely awful at home. Chris is angry and the situation just kept getting worse. Now that he's away from us, and we're away from him, he has a chance to regain his bearings."
The simple explanation put forward by people who know Chris best (his family) was not taken seriously enough. Dr. X was having none of it. While we all had feel good words of encouragement for each other at our meeting, Dr. X was determined to tinker with the low dose of the one med that Chris on. We had managed to keep Chris's dose at 10 mg for almost a month, but the pressure was on to add another antipsychotic at a similar low dose. Why? I believe for no other reason than because the health care system we are under believes in two low dose antipsychotics taken concurrently. Dr. X didn't say that, of course. He said he thought Chris could improve some more if we just found the right combination of drugs. "Yeah, right", I thought, "and I bet he would also improve just by coming home". Then a darker thought intruded: "What's the particular relationship here between the drug prescribed and, say, funding a new wing, of this hospital?"
Why couldn't they just leave well enough alone? Chris was improving anyway just by getting away from us. Families need a break from their psychotic relatives, but there is nowhere a patient can go under medical supervision where he can just get on with it without drugs. Time and distance is a great healer, too, but this goes unrecognized in today's mental health system. To an institution, it's all about the drugs. Dr. X went as far as to tell me that the "newest" research says that people should continue on low doses of antipsychotics for a long time, and not go off them. I think that the pharmaceutical companies are writing the script here.
The drugs are placebos at best, in my opinion. A drug, to me, is effective if you no longer have symptoms or ugly side effects, and that is not the case with antipsychotics. One measure of the effectiveness of a medication is how long the patient adheres to taking it. A Wall Street Journal report of a 2005 study by the National Institute of Mental Health, stated: “Nearly three-quarters of people treated stopped taking the medicine they had been given within 18 months, due to side effects or poor control of symptoms.” The Washington Post noted: “The surprising result of a federally funded study released yesterday challenges widespread assumptions among psychiatrists about the best way to treat serious mental illness and underscores the extent to which physicians, patients and policymakers can be blindsided by self-interested research by drugmakers.” This will come as no surprise to anyone who has a mentally ill relative. We have been saying this for years, but no one, it seems, listens to us.
The pathetic explanation of why Chris ended up back on two antipsychotics, after having being weaned off them through the judicious use of supplements and alternative therapies boils down to I got tired of being the odd one out. When Chris started to go downhill, everybody but everybody was clamoring for us to medicate him. The only hold out other than me was the holistic psychiatrist, and unfortunately, she lives far away. Chris also didn't help his case or mine by going psychotic.
Our relationship with the holistic psychiatrist died when we put Chris in the hospital. In her opinion, we, meaning Chris and his parents, failed to prevent Chris from going nuts. Working with her was great while it lasted because she taught us so much about healing. I am knowledgeable enough now about vitamins and supplements to continue working on my own with Chris. I am not looking forward to fighting a new war on the medication front, at least not for now.
The doctors will credit any progress Chris makes in future with his being on medications. If Chris, for whatever reason, does poorly, they will want to raise the medications rather than help him deal with his problems holistically.
______________________________________________ Federal Study Finds No Benefit of New Antipsychotic Drugs - WashPost/Wall StreetJ/NY Times, Tues 20 Sep 2005; New Antipsychotic Drugs Criticized, Federal Study Finds No Benefit Over Older, Cheaper Drug - Washington Post, Tuesday, September 20, 2005 http://www.ahrp.org/infomail/05/09/20.php