Cognitive therapy: at last an alternative to antipsychotics?

Schizophrenia causes substantial disability and premature mortality, and is one of the top causes of disease burden worldwide. Antipsychotic drugs revolutionised schizophrenia treatment when introduced in the 1950s, and numerous studies have shown that antipsychotics are effective for acute episodes, and as maintenance treatment, with a number needed to treat of 3 to prevent relapse. Evidence has also shown that some drugs could reduce mortality, mainly through a reduction in suicide rates. However, the clinical reality is that many patients stop taking antipsychotics for various reasons: side effects, absence of benefit, disorganisation, and because they do not perceive they have an illness.

The Lancet
Published online February 6, 2014