Schizophrenia is a major mental health issue that is often treated with antipsychotic drugs, but a new study has found that talking therapies may also be effective for the wellbeing of sufferers. While this could be a major breakthrough – as antipsychotic drugs can be ineffective or come with unpleasant side effects – you might not want to throw out your medications just yet.
The study was a randomised controlled trial (RCT) of 74 people with schizophrenia who were no longer taking antipsychotics, carried out by researchers from the universities and NHS mental health trusts of Manchester and Newcastle-upon-Tyne, and funded by the National Institute for Health Research. Still, while talk therapies showed a small improvement to the symptoms of schizophrenia, the NHS has cautioned that the study has its limits, and those taking medication for a schizophrenia spectrum disorder should not stop based on the results of this study.
During the study, the results of which were published in the peer-reviewed medical journal The Lancet, participants were allocated to either receive CT for up to nine months or “treatment as usual”, and the results showed that CT can lead to small improvements in symptoms and social function for people with schizophrenia spectrum disorders. Although antipsychotic drugs are a widely used treatment for schizophrenia, many sufferers find that the side effects of the drugs take a toll on their wellbeing. These wellness symptoms include weight gain and drowsiness, and so any research that looks into alternative therapies is helpful. However, if you are taking medication for a schizophrenia spectrum disorder, it is important that you do not suddenly stop taking your drugs. Discuss any concerns you might have with your key worker or psychiatrist.
The results of the study revealed a very small improvement in overall positive symptoms of -2.22 (95% CI: -4.00 to -0.44) and overall general symptoms of -3.63 (95% CI -5.99 to -1.27), but the same improvement was not seen on negative symptoms. The researchers reported, ‘Therapy did not significantly affect the amount of distress associated with delusional beliefs or voice hearing, or levels of depression, social anxiety and self-rated recovery.’ They concluded that the ‘findings suggest that cognitive therapy is an acceptable, safe and effective treatment alternative for people who choose not to take antipsychotics. Evidence-based treatments should be available to these people. A larger definitive trial is needed to confirm the clinical implications of our pilot study.’
Yet, according to the NHS website, ‘The study design has strengths in that it attempted to blind the assessors as to which treatment the participants were receiving. It also recruited participants who did not want to take antipsychotic medication and had not done so for six months before the study. However, 10 people in each group did take antipsychotics during the trial. This complicates the results, as it is not clear whether the improvements were as a result of the CT, the medication or a combination of both.’
The NHS also warns, ‘A further point that the researchers raise is that it is not clear whether the specific type of talking therapy is important, or whether the contact time, warmth and empathy that was received in the CT group was the factor that made the difference. Schizophrenia spectrum disorders cover a wide range of symptoms and each person has a different individual experience of their illness. This study contributes to previous research, which has shown that CT can be beneficial for people with the condition. However, importantly, it does not show that it is better or equivalent to antipsychotic medication. The participants continued to have moderate levels of illness despite receiving therapy.’
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