A Possible Monotherapy for Schizophrenia

schizophreniaNew research suggests that cognitive therapy may be a possible alternative to antipsychotic medicines for patient with schizophrenia who cannot or will not take them.[1] The first randomized trial of cognitive therapy as a monotherapy for schizophrenia found results that it reduced the severity of psychiatric symptoms and improved personal and social functioning, as well as some dimensions of delusional beliefs and voice hearing.1

Antipsychotic drugs are still the first-line treatment for patients with schizophrenia; however, as approximately half of those who are diagnosed with schizophrenia choose not to take their medicines or discontinue them due to uncomfortable side effects, alternative treatments should be studied.1 In the past, cognitive therapy has be proven to be effective when used in combination with antipsychotic medicines; however, it has not been until now that it has been tested for its effectiveness as a monotherapy.1

Anthony Morrison, DClinPsy, and colleagues from the University of Manchester in the United Kingdom completed a study of 17 individuals, aged 16 to 65, who were diagnosed with schizophrenia spectrum disorders and decided to not take, or stop taking, antipsychotic medications for at least six months.1 The participants were assigned to cognitive therapy as a sole treatment.1

With cognitive therapy, a therapist works with the patient in weekly sessions to reappraise psychotic experiences and modify unhealthy thought patterns and behaviors.1 In the past, the therapy has been proven to reduce psychotic symptoms and improve function.1 After 18 months, 7 of the 17 participants receiving cognitive therapy alone made more than a 50 percent improvement on the Positive and Negative Syndrome Scale (PANSS).1

While these results were impressive, caution is still needed.1 Not all patients fit the criteria to be treated with cognitive therapy alone, especially those with severe schizophrenia and those who are in inpatient treatment centers or do not have a clinical team.1

These results need further testing before such therapy can be offered, as schizophrenia is a complex disease that often needs antipsychotic treatment for the safety of the patient and others.1

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