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Schizophrenia Bulletin Advance Access published online on October 27, 2005
Schizophrenia Bulletin, doi:10.1093/schbul/sbj019
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© The Author 2005. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Article

Medication-Free Research in Early Episode Schizophrenia: Evidence of Long-Term Harm?

John R. Bola 1*
1 School of Social Work, University of Southern California

* To whom correspondence should be addressed.
John R. Bola, E-mail: bola{at}usc.edu


  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.

Keywords: psychosis; first episode; meta-analysis; spontaneous remission; subgroup; subtype.
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