Comment Re:Good luck (Score 1) 218
For some patients (perhaps about half) long-term outcomes for schizophrenia are reasonably functional. (Harding CM et al, The Vermont longitudinal study of persons with severe mental illness, Am J Psychiatry 1987: 144: 718.) For the other half, even on medication, they progressively deteriorate. It's a bummer for probably all of the latter and many (most?) of the former to not take their medicine, for everyone - they don't seem any happier, as agitation and paranoia tend to increase, and unmedicated psychosis is where ideas about pushing people in front of buses ferment. My sympathy is firm: I wouldn't want to take the pills either, what with varying degrees of fatigue (though this usually abates in most patients after a few weeks), weight gain, increasing cholesterol and blood sugar. I feel bad about the guys gesticulating wildly on the street, and though it's arguable their fate is better off than when us North Americans routinely institutionalized such people, it's hard not to feel they've been abandoned.
I'm not aware of antipsychotics causing physical or psychological dependence (using the clinical meaning of drug dependence), and I'm not aware of habituation either. I'd be interested in any such references. If I can get patients to take the pills, they do not seem to need more antipsychotics over time, nor do they withdraw when they stop taking them. I'm truly happy for people who can safely manage their hallucinations without medication, but for a great many patients - probably most - they really seem better off on antipsychotics.