Harrow + Wunderink + Open Dialogue = An Evidence-based Mandate for A New Standard of Care
In the wake of the new study by Dutch researcher Lex Wunderink, it is time for psychiatry to do the right thing and acknowledge that, if it wants to do best by its patients, it must change its protocols for using antipsychotics. The current standard of care, which—in practice—involves continual use of antipsychotics for all patients diagnosed with a psychotic disorder, clearly reduces the opportunity for long-term functional recovery. (MIA writer Sandy Steingard recently wrote about the Wunderink study, which was published on July 3 in JAMA Psychiatry online.)
The Wunderink study, precisely because it had a randomized design, complements Martin Harrow’s study of long-term outcomes in a very compelling way. In addition, the results reported by Open Dialogue practitioners in northern Finland provide a data-based sense of what would be possible if psychiatry amended its protocols for using antipsychotics based, in large part, on the findings in the Harrow and Wunderink studies.
Here is how the three studies fit so nicely together to form a compelling evidence-based rationale for changing prescribing standards.