Wednesday, 16 March 2011

NICE's mistake in their clincal guidelines for schizophrenia

The UK's organisation which writes their clinical guidelines, NICE, is one of the most respected in the world.

They failed to live up to their expectations when they revised their schizophrenia guidance.

They failed in their non-pharmocological intervention recommendations and persist in recommending a dangerous antipsychotic with known risks after two trials of other antipsychotics.

They recommend based on a fundamentally flawed evidence model with respect to patient desires. They have their own judgement system upon which their entire evidence base is based upon.

Their valuation of major tranquiliser medication is based on a false assumption. The dopamine hypthesis is about removing the expression of the phenotype by chemical means. What a patient wants in first epidosde psychosis is removal of the delusions or hallucinations more than anything else.

Antipsychotics are not definitely proven to do this. Reduction of delusions is one of the many aspects of the measures of the quantitive research in the area. The qualitative research, research done by the manufacturer, shows the most dangerous antipsychotic only works for "some" people.

Other studies read shows the major tranquiliser clozapine is a potent behavioural change agent. The value it has in psychiatry is beyond all other drugs. In truth the value is not what patients want before they've gone through the journey to accept their delusions. The value of the drug is on psychiatric ones,not patient ones.

You find me one psychiatrist who would take clozapine and i'd show you a unqiue individuals. These drugs are not experienced by the dealers. This last point is signifcant. I'm tired. I'll stop writing for now.

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"