I just listened to ASCP President Dr. John Kane give a perspective at NCDEU on the treatment of schizophrenia—past, present, and future. Chairman of Psychiatry at LIJ-Hillside in New York, John is an internationally renowned expert in this area. Among many perceptive points in his rich talk, two caught my attention.
Based on research from his group over many decades, Dr. Kane estimates the incidence of new tardive dyskinesia cases among patients taking first-generation antipsychotics as 5% per year. This contrasts with an incidence in second-generation drugs of only 1% per year. As I wrote in a recent blog, this makes a huge difference in the lives of patients who take these medicines. Score this advantage for the second generation.
A second point concerns the health burden borne by the chronically mentally ill. These patients commonly eat unhealthy diets and lead sedentary lives. They take medicines that may add body weight and impair lipid and glucose metabolism. They often smoke. And they tend to get poor medical care. All of these issues are familiar to BTP readers. John Kane proposes that psychiatrists assume a greater role in the primary care of the chronically mentally ill. Even when a medical problem is outside of a psychiatrist’s expertise, we can act as advocates and help our patients navigate the health care system. It makes good sense and can prolong lives and enhance the quality of patients’ lives.