Is it open dialogue or the absence of neuroleptic that cures psychosis?


(Sylvain Rousselot) #1

In the Harrow study (2014, p.4, Fig. 3) 93% of people diagnosed with schizophrenia who had never taken a neuroleptic had ceased to be psychotic after 4 years. They could have other problems, but at least the psychosis was behind them. This rate is apparently better than that of the Open Dialogue.

This suggests that the results of the Open Dialogue could be explained more by what it does not do, and less by what it does. In particular, the reduction of neuroleptic consumption, the decrease in the number of hospitalizations, etc.

It is likely that the effectiveness of the Open Dialogue is largely a matter of doing nothing, except talking, not taking a harmful step, and waiting for the psychosis to end.

There is formal evidence that neuroleptics slow or prevent recovery, and that without neuroleptics, the schizophrenic condition is not chronic (93% are no longer psychotic after 4 years). Thus, it is not “few neuroleptics” that must be given, but “none”. It is not “not much hospitalization” that is necessary, but “none”.

In the same way that a doctor never prescribes heroin to relieve suffering - and not only because it is forbidden - he must not prescribe neuroleptics to relieve psychosis - even if it is allow. The gross empiricism of psychiatry must give way to the true sciences of sociology, psychology and anthropology, with the support of addictology and neurology which show how psychotropic are harmful to the body and to the soul.

Harrow, M., Jobe, T. H., Faull R. N. (2014) Does treatment of schizophrenia with antipsychotic medications eliminate or reduce psychosis? A 20-year multi-follow-up study. Psychological Medicine, Page 1 of 10. © Cambridge University Press 2014 doi:10.1017/S0033291714000610 Repéré à http://www.mentalhealthexcellence.org/wp-content/uploads/2013/08/HarrowJobePsychMedMarch2014.pdf


(Thalia) #2

Thank you for this fascinating article - it’s so important that this kind of research is circulated widely. I was amazed that they could find some people in Chicago diagnosed as “schizophrenic” who weren’t on medication! And the fact that they did so much better in the long run is very telling. I wonder what treatment they were getting, if any.
Thalia