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Medication-Free Research With Schizophrenic Patients: A European Perspective

Medication-Free Research With Schizophrenic Patients: A European Perspective Abstract THE ARTICLE by Carpenter et al1 in this issue of the ARCHIVES presents a clear evaluation of the role of medication-free research in schizophrenia and discusses the ethical implications of such research. The authors argue that medication-free research offers distinct advantages in treatment trials and that the risks for relapse can be limited through careful patient selection, close clinical monitoring, and psychosocial treatments. They further discuss the role of medication-free research in probing questions concerning etiology and provide some assessment of the issues in determining the risk-to-benefit ratio in these cases. They also suggest some relevant guidelines for patient selection in carrying out medication-free research. Finally, they provide some thoughtful insights on the issue of informed consent. They conclude that medication-free research in schizophrenia is clearly worthwhile and even necessary in treatment evaluations and in studies aimed at understanding etiology and that reasonable guidelines should be established by References 1. Carpenter WT Jr, Schooler NR, Kane JM. The rationale and ethics of medication-free research in schizophrenia . Arch Gen Psychiatry . 1997;54:401-407.Crossref 2. Helmchen H, Lauter H. Ethische Probleme beider biomedizinischen Forschung mit kognitiv beeinträchtigten älteren Menschen . Nervenarzt . 1995;66:231-238. 3. Grisso T, Appelbaum PS. Comparison of standards for assessing patients' capacities to make treatment decisions . Am J Psychiatry . 1995;152:1033-1037. 4. reen AI, Faraone SV, Brown WA, Gutterez J, Tsuang MT. Neuroleptic dose reduction studies: clinical and neuroendocrine effects. Presented at the 31st annual meeting of the American College of Neuropsychopharmacology; December 15, 1992; San Juan, Puerto Rico. 5. GBaldessarini RJ, Viguera AC. Neuroleptic withdrawal in schizophrenic patients . Arch Gen Psychiatry . 1995;52:189-192.Crossref 6. Gilbert PI, Harris MJ, McAdams LA, Jeste DV. Neuroleptic withdrawal in schizophrenic patients: review of the literature . Arch Gen Psychiatry . 1995;52:173-188.Crossref 7. Wyatt KJ. Neuroleptics and the natural course of schizophrenia . Schizophr Bull . 1991;17:325-351.Crossref 8. Crow TJ, Macmillan JF, Johnson AL, Johnstone EC. A randomized controlled trial of prophylactic neuroleptic treatment . Br J Psychiatry . 1981;148:120-127.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Medication-Free Research With Schizophrenic Patients: A European Perspective

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Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1997.01830170028003
Publisher site
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Abstract

Abstract THE ARTICLE by Carpenter et al1 in this issue of the ARCHIVES presents a clear evaluation of the role of medication-free research in schizophrenia and discusses the ethical implications of such research. The authors argue that medication-free research offers distinct advantages in treatment trials and that the risks for relapse can be limited through careful patient selection, close clinical monitoring, and psychosocial treatments. They further discuss the role of medication-free research in probing questions concerning etiology and provide some assessment of the issues in determining the risk-to-benefit ratio in these cases. They also suggest some relevant guidelines for patient selection in carrying out medication-free research. Finally, they provide some thoughtful insights on the issue of informed consent. They conclude that medication-free research in schizophrenia is clearly worthwhile and even necessary in treatment evaluations and in studies aimed at understanding etiology and that reasonable guidelines should be established by References 1. Carpenter WT Jr, Schooler NR, Kane JM. The rationale and ethics of medication-free research in schizophrenia . Arch Gen Psychiatry . 1997;54:401-407.Crossref 2. Helmchen H, Lauter H. Ethische Probleme beider biomedizinischen Forschung mit kognitiv beeinträchtigten älteren Menschen . Nervenarzt . 1995;66:231-238. 3. Grisso T, Appelbaum PS. Comparison of standards for assessing patients' capacities to make treatment decisions . Am J Psychiatry . 1995;152:1033-1037. 4. reen AI, Faraone SV, Brown WA, Gutterez J, Tsuang MT. Neuroleptic dose reduction studies: clinical and neuroendocrine effects. Presented at the 31st annual meeting of the American College of Neuropsychopharmacology; December 15, 1992; San Juan, Puerto Rico. 5. GBaldessarini RJ, Viguera AC. Neuroleptic withdrawal in schizophrenic patients . Arch Gen Psychiatry . 1995;52:189-192.Crossref 6. Gilbert PI, Harris MJ, McAdams LA, Jeste DV. Neuroleptic withdrawal in schizophrenic patients: review of the literature . Arch Gen Psychiatry . 1995;52:173-188.Crossref 7. Wyatt KJ. Neuroleptics and the natural course of schizophrenia . Schizophr Bull . 1991;17:325-351.Crossref 8. Crow TJ, Macmillan JF, Johnson AL, Johnstone EC. A randomized controlled trial of prophylactic neuroleptic treatment . Br J Psychiatry . 1981;148:120-127.Crossref

Journal

Archives of General Psychiatry – American Medical Association

Published: May 1, 1997

References

  • The rationale and ethics of medication-free research in schizophrenia
    Carpenter WT Jr, Schooler NR, Kane JM
  • Ethische Probleme beider biomedizinischen Forschung mit kognitiv beeinträchtigten älteren Menschen
    Helmchen H, Lauter H
  • Comparison of standards for assessing patients' capacities to make treatment decisions
    Grisso T, Appelbaum PS
  • Neuroleptic withdrawal in schizophrenic patients
    GBaldessarini RJ, Viguera AC
  • Neuroleptic withdrawal in schizophrenic patients: review of the literature
    Gilbert PI, Harris MJ, McAdams LA, Jeste DV
  • Neuroleptics and the natural course of schizophrenia
    Wyatt KJ
  • A randomized controlled trial of prophylactic neuroleptic treatment
    Crow TJ, Macmillan JF, Johnson AL, Johnstone EC