The Best Treatment for Psychotic Illness is no Secret.

By Dr David Laing Dawson

Nor does it require argument and more research comparing one component to another. This is it:

  • Early intervention, thorough assessment.
  • Treatment with medication by a knowledgeable physician/psychiatrist.
  • A good working relationship between psychiatrist and patient and his or her family.
  • Adequate housing with support.
  • A supportive family.
  • Ongoing education for patient and family about illness and treatment.
  • A wise, grounded counselor/therapist/support worker.
  • Easy access and rapid response support team for crises and emergencies.
  • Healthy diet and exercise.
  • Good general medical care.
  • Membership, belonging to a group or organization of some kind.
  • Daily routine.
  • An activity that provides some sense of worth and value.

When the support systems are in place, and a good working relationship has developed between the psychiatrist and patient and family, pharmacological treatment can be (safely) titrated down (or up) to the lowest effective maintenance dosages. Occasionally, with close monitoring over a long period of time, this can mean trials of no medication.

In the real world there are dozens of reasons this ideal is not often achieved, or only partially achieved. And some of those reasons include the interminable nonsense spouted by the Mad in America Group, inter-professional rivalries for prestige and money, illness deniers, would-be gurus, and politicians and planners listening to this nonsense.

13 thoughts on “The Best Treatment for Psychotic Illness is no Secret.

  1. Absolutely spot on and this is the only approach that is sensible. It is basically the approach that they took in RAISE. The only caveat I would add is if an antipsychotic is needed it should be clozapine. In my hands and others the early use of clozapine has been remarkably well tolerated with outstanding pscychosocial benefits. Additionally the use of early clozapine dramatically improves overall mortality by decreasing the suicide rate. Finally when clozapine is used early in psychosis the dosages required more often then not are much lower than is the usual convention.

    Liked by 1 person

  2. I completely agree, but my son who is diagnosed w/ schizophrenia – is not cooperative. He has not had good experiences with psychiatrists. So, really challenging right now.


      1. Anosognosia, the unawareness of the illness, is a very common problem in psychotic disorders. Xavier Amador, who I consider the Godfather of this subject, estimates that over 50 % are so afflicted. I highly recommend that you read his book I am sick I don’t need help. Over the last several years I have used his LEAP approach with some success. A relationship with the person and his or her family is the critical starting point. I refer you to my charity website for further information on my approach. All of my best


    1. I’ve read the book and I use his LEAP, however, my son calls me on this approach, says I’m an idiot. I will re-read the book. I’ll check out your website.


      1. Betsy reread the book and if you can get to hear him on Youtube. Reflective listening is not an easy tool to learn. I still am struggling not to slip into old habits. It is never easy but never give up hope.


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