Full Disclosure: Toward a Participatory and Risk-Limiting Approach to Neuroleptic Drugs

Abstract

Following the many clinical studies of neuroleptic treatment and the resulting practice guidelines and algorithms that have been established by various psychiatric associations, there seems to be little room for considering other treatment concepts that may be at variance with these guidelines: the earlier and the more sustainedly that neuroleptics are taken, the better—this is currently the widely accepted basic principle. If this were indeed correct, service users would have only negligible input into their treatment with neuroleptics. For therapists, there would be little more to do than to inform patients fully about these medications and their untoward effects. The elbow room could be substantially increased if clinical experiences and scientific results that are frequently ignored were to be considered. Such information will be presented in this article, with the aim of enhancing the agency and creativity of users and mental health professionals and of advocating for patient-centered and context-oriented advances in psychiatry. Critical assessments of neuroleptic treatment will be followed by a presentation of the therapeutic potential of complex psychosocial interventions, which enable the avoidance of neuroleptic medications in 40%–70% of instances; and finally, the principles of an approach that we would call participatory neuroleptic treatment will be outlined.