title: Medication-free research in early episode schizophrenia: evidence of long-term harm?
abstract: This study investigates the question of whether short periods of medication-free research in early episode schizophrenia result in demonstrable long-term harm to human subjects. A meta-analysis of published quasi-experimental and random assignment studies that had a majority of first- or second-episode schizophrenia spectrum subjects, at least 1 initially unmedicated group, and a minimum of 1-year results was conducted. Only 6 studies, with 623 subjects, met inclusion criteria. The initially unmedicated groups showed a small, statistically nonsignificant long-term advantage (r = -0.09). Incorporating only random assignment studies into a composite effect size produced a similar near-zero result (r = 0.01). Good-quality evidence is inadequate to support a conclusion of long-term harm resulting from short-term postponement of medication in early episode schizophrenia research. A categorical prohibition against such research should be reconsidered.
authors.affiliation: School of Social Work, University of Southern California, USA. bola@usc.edu
authors.forename: John R
authors.initials: JR
authors.lastname: Bola
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012075:Remission, Spontaneous; D018570:Risk Assessment; D012559:Schizophrenia / Q000188:drug therapy*; D013997:Time Factors; D028761:Withholding Treatment
chemical_list: D014150:Antipsychotic Agents