Posted by SLS on September 13, 2009, at 9:09:41
In reply to Re: Suggestions re: Someone Who Refuses Medications » SLS, posted by 49er on September 13, 2009, at 7:12:52
Again, I agree with you that antipsychotics should be tapered. I even like your suggestion to restart a medication if withdrawal symptoms appear as the result of an abrupt discontinuation. However, I don't know how you can justify the necessity to follow your formula of a 5% reduction every 3-6 weeks. I'm going to let you do a little math for me. How many weeks would it take to arrive at a total discontinuation of an antipsychotic at the taper rate you recommend?
Regarding the variation in the presentation of schizophrenia and the issue of competency to make treatment decisions, I guess we differ on what each of us has experienced as observers of people afflicted with schizophrenia or psychotic mania. I have first hand experience with the latter. To be clear, I am not advocating the forced medicating of people who are functional enough to remain as outpatients. However, I think there are times when encouragement to accept medication is critical, despite the verbalizations of the patient. There isn't necessarily a lack of respect for patients, but there can be lack of confidence in their judgment and a disagreement as to what is best for their welfare. That's part of the job of the health workers overseeing the care of others, regardless of the nature of the illness. It is unfortunate that, in mental illness, the processes that are necessary to effectively deliberate decisions are impaired in many cases. I think this is what separates these illnesses from all others.
- Scott
poster:SLS
thread:915268
URL: http://www.dr-bob.org/babble/20090912/msgs/916846.html