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Interview with Dr John Kane on Advances and Limitations in Psychopharmacology, SIRS, April 2014
Dr John Kane, Chairman of Psychiatry at The Zucker Hillside Hospital, talks about the advances that have been made in psychopharmacology, but also of his disappointment at a lack of revolutionary new treatments based on new mechanisms. He cites relative successes with controlling symptoms, but also the need to improve rates of recovery. He explains his ongoing study Recovery After an Initial Schizophrenia Episode (RAISE) which treats first episode patients with a state of the art combination of psychopharmacology and psychosocial treatments, with the hope that well-structured early interventions can increase rates of recovery and ultimately improve quality of life.
- We've had antipsychotics for 60 years. Some say we've made no progress while other consider that the field has made major advances. What's your opinion?
- In terms of recovery, what are the components of the illness that you think we are furthest away from achieving?
- Do you think that with current medications there is enough beneficial effect on cognition and negative symptoms?
- There is evidence that there are morphological brain changes before the onset of the first episode. Do you think it's realistic to develop interventions that can get patients back to baseline?
- Aside from improvements in pharmacology, do you think there is greater room for improvement with issues like non-adherenec and substance abuse? Do you regard managing these as high priorities?
- Current treatments focus around the DA hypothesis of scizophrenia. Are there new avenues to be explored to provide more comprehensive outcomes in patients?
- Do you believ ethe early years of the illness are a critical period in determining the long term outcome of patients?
- What is your ideal approach to treating a young person presented for the first time with a schizophrenic illness?