Recovery From Schizophrenia: Psychiatry And Political Economy

ANTIPSYCHOTIC DRUGS: USE, ABUSE AND NON-USE 233Figure 10.2 Relapse rates of schizophrenic patients in high- and low-stress familiesSource: Vaughn, C.E. and Leff, J.P., “The influence of family and social factors on thecourse of psychiatric illness: A comparison of schizophrenic and depressed neuroticpatients,” British Journal of Psychiatry, 129:125–37, 1976.—a property that is thought to contribute to their antipsychotic effect. Thisevidence, then, also implies that antipsychotic drugs may be less necessary wherethe social environment is therapeutic and non-stressful.The level of arousal in people with schizophrenia in hospital or residentialtreatment can be controlled by creating an environment that is optimallystimulating and supportive. In such a setting drug treatment is minimallynecessary. Long-stay hospital patients withdrawn from low-dosage maintenancedrugs, according to psychologist Gordon Paul’s 1972 review of the research,rarely show harmful effects, and a majority of the relevant studies indicates thatdrug treatment is not necessary for such patients when they are in a progressivepsychosocial treatment program. 42One such study is Gordon Paul’s own report on a drug-withdrawal projectinvolving 52 severely incapacitated, long-stay patients with schizophrenia in anIllinois state hospital. The patients were transferred to two active psychosocialtreatment programs and matched groups were assigned to either continuation of