Talk:Psychosis

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Former featured article Psychosis is a former featured article. Please see the links under Article milestones below for its original nomination page (for older articles, check the nomination archive) and why it was removed.
Main Page trophy This article appeared on Wikipedia's Main Page as Today's featured article on February 27, 2004.
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Date Process Result
January 19, 2004 Refreshing brilliant prose Kept
October 25, 2006 Featured article review Demoted
Current status: Former featured article
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Protected[edit]

The article has been full-protected for a few days due to the ongoing multi-party editing dispute. Please work out your differences regarding the content on the Talk page and come to a consensus. Thanks... Zad68 22:36, 1 October 2014 (UTC)

I have investigated this a bit more closely and I have upped the full-protection to a full week due to concerns about canvassing/meat-puppetry. Please use this time to familiarize yourself with Wikipedia content and behavior rules, and work collaboratively to build consensus for content change suggestions. Suggestions that have a firm consensus here on the Talk page may of course be implemented before the full protection expires. Zad68 02:08, 2 October 2014 (UTC)


So sorry about this overzealous behavior on my part. It was based on ignorance. I have read the talk page on psychosis and understand the respectful tone there. I will inform the MIA readers of this and always go for consensus. Ex-nimh-researcher (talk) 07:58, 3 October 2014 (UTC)

How about adding a subsection “controversy” , controversy over treatment of psychosis or something like that ?

2.150.25.23 (talk) 10:47, 4 October 2014 (UTC)

First thing we need is some high quality secondary sources that discuss the issue and then we can discuss. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:47, 4 October 2014 (UTC)
The lede contains the sentence:
"Many antipsychotic drugs accordingly target the dopamine system; however, meta-analyses of placebo-controlled trials of these drugs show either no significant difference in effects between drug and placebo, or a moderate effect size, suggesting that the pathophysiology of psychosis is much more complex than an overactive dopamine system.[8][9]"
I don't think anyone will dispute the obvious sentence "the pathophysiology of psychosis is much more complex than an overactive dopamine system", but the rest of this sentence represents cherry picking and WP:OR.
NICE recommends antipsychotics as first line therapy for schizophrenia, stating on the basis of an extensive sytematic review:
"For people with first episode psychosis offer: oral antipsychotic medication (see sections 1.3.5 and 1.3.6) in conjunction with psychological interventions... Advise people who want to try psychological interventions alone that these are more effective when delivered in conjunction with antipsychotic medication.(http://www.nice.org.uk/guidance/cg178/chapter/1-recommendations")
They are a first line treatment recommendation by the British Association for Pharmacology, which says they are "effective" . http://www.bap.org.uk/pdfs/Schizophrenia_Consensus_Guideline_Document.pdf
The Cochrane group has reviewed many of these drugs. Recent meta analyses stated:
"Our results agree with existing evidence that compared to placebo, trifluoperazine is an effective antipsychotic for people with schizophrenia."(https://www.ncbi.nlm.nih.gov/pubmed/24414883)
"Chlorpromazine, in common use for half a century, is a well-established but imperfect treatment."(https://www.ncbi.nlm.nih.gov/pubmed/24395698)
"Haloperidol is a potent antipsychotic drug but has a high propensity to cause adverse effects. Where there is no treatment option, use of haloperidol to counter the damaging and potentially dangerous consequences of untreated schizophrenia is justified." (https://www.ncbi.nlm.nih.gov/pubmed/24242360)
The NIMH states that upon treatment with antipsychotics, "Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of improvement."http://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml"
There are in fact very few meta analyses that show "no significant difference in effects between drug and placebo", and those that do refer mostly refer to specific drugs, not to antipsychotics as a group. Clearly these drugs are far from optimal in terms of efficacy and side effects. But any statement to the effect that they have "no significant effects" is a minority position at best, and fringe at the worst. We certainly should not have this one sided comment presenting the minority viewpoint in the lede. Formerly 98 (talk) 21:18, 8 October 2014 (UTC)