Respectfully, here's my clarification, @Keith_Laws (cc @niallc74):
You sent a tweet that says, "Excellent meta analysis by Leucht on antipsychotics & relapse prevention - free here http://bit.ly/SOsc5W @niallc74"
Shortly thereafter, @niallc74 retweeted your tweet (so I saw the tweet 'floating' in my Twitter stream).
I checked out the study you were recommending.
In doing so, something popped out, as problematic, about the researchers' conclusions...
(At least, that was/is my impression.)
So, I sent you both two tweets.
Here's the first tweet I sent you,
"Note prominently p. 5: "Antipsychotics were mostly withdrawn abruptly, [only] 11 studies included gradual withdrawal" @Keith_Laws @niallc74"
Here's the second tweet I sent you,
"Naturally, abrupt withdrawal leads to seeming 'relapse,' as abrupt withdrawal symptoms are the result. @BeyondLabeling @Keith_Laws @niallc74"
"@BeyondLabeling @niallc74 Sorry , not understanding what you are saying?"
Keith, the researchers' "Interpretation" of their meta-analysis study is, that, "Maintenance treatment with antipsychotic drugs benefits patients with schizophrenia. The advantages
of these drugs must be weighed against their side-effects. Future studies should focus on outcomes of social
participation and clarify the long-term morbidity and mortality of these drugs."
I am pointing out, to you (and to @niallc74): Their study regards 65 trials, only 11 of which studied *gradual* withdrawal from those drugs.
I.e., the vast majority of the trials they studied were looking at effects of *abrupt* withdrawal from the drugs.
And, everyone who knows anything at all, about these drugs, knows, that: abrupt withdrawal leads to severely disabling effects, almost always.
Indeed, those effects tend to look like 'relapse' of the original 'symptomology' - or worse.
So, of course, they're going to be looking at a lot of seeming 'relapse' of so-called symptomology, in this particular meta-analysis.
It's really a whole lot of severe *withdrawal* effects, that's being recorded, in most of those studies, and the researchers' "interpretation" of their meta-analysis is failing to emphasize that very important point.
Therefore, it's my opinion that the researchers' interpretation is sorely lacking.
If, perhaps, you have time, here's an interesting paper on the 'meta-analysis' process...
Clinical judgment in psychiatry.
Requiem or reveille? (by GIOVANNI A. FAVA)