Can Medication-Free Research Ever Be Ethical in Older People With Psychotic Disorders?
The history of medicine demonstrates that apparently logical ideas sometimes prove to be inaccurate when subjected to empirical research. In psychopharmacology, repeated antipsychotic discontinuations (drug-free intervals) used to be strongly recommended for treating patients with schizophrenia with the presumption that they would prevent tardive dyskinesia.1 Yet, a subsequent empirical study found that intermittent drug treatment was associated with an increased risk of persistent tardive dyskinesia.2 Now, Bola’s thought-provoking review (this issue) shows that the relevant empirical data do not support the previous notion of untreated psychosis causing long-lasting neurobiological damage. (This is not to question the serious consequences of relapse that may follow antipsychotic withdrawal.) How ethical is antipsychotic-free research in older persons with schizophrenia or other psychotic disorders? The article by Bola does not address this issue directly because the studies included i