A new study demonstrates that far more people are able to fully recover from psychosis than typically thought—and that many can do so without antipsychotic drugs.
The researchers followed 28 people for 10 years after their first episode of psychosis, documenting the road to recovery along the way.
They used a strict definition of recovery, which involved remission of psychosis symptoms for at least two years, as well as a return to functioning as indicated by employment, socializing, and other metrics. Even with this strict definition, by the 10-year mark, 14 people (50%) met the criteria for full recovery. Twenty people (71%) met the looser definition of “remission” at the 10-year mark. And half of those who recovered (7 people) had stopped taking antipsychotics.
Much of this recovery began early, too, with 55% meeting a “clinical recovery” benchmark by year 4.
“Consistent with prior research, our findings indicate that a significant number of individuals … experience symptom remission within the initial year of illness. For some, this remission leads to sustained clinical recovery, even without the use of continued antipsychotic medication,” the researchers write.
The study was conducted by Anne-Kari Torgalsbøen, Christine Mohn, Frank Larøi, and Nikolai Czajkowski at the University of Oslo, Norway. It was published in Frontiers in Psychiatry.
This finding is consistent with previous research showing that antipsychotic drugs worsen, rather than improve, outcomes in first-episode psychosis. Other studies have found similar poor outcomes for those “at risk” of psychosis who take the drugs. Ultimately, those who use the drugs long-term have worse outcomes, even after accounting for baseline severity and other factors. Indeed, those who reduce or discontinue the drugs are more than twice as likely to recover than those who continue using antipsychotics. Those who take the most drugs for the longest period have the worst outcomes, including higher mortality rates.
The current study comes out of the Oslo Schizophrenia Recovery (OSR) project, which involved 28 patients with a first episode of psychosis in southeastern Norway (including Oslo) between 2007 and 2011. Participants were at least 18 years old and had a schizophrenia syndrome diagnosis. They were tracked with 12 evaluations over the course of 10 years; the current study reports the 10-year results. By the 10-year mark, six patients had dropped out, leaving 22 in the final analysis.
The general trend was improvement until year 4, when the trend more or less stabilised. By year 10, 14 of the remaining 22 participants were considered recovered in terms of both psychosis symptoms and global functioning. That’s about two-thirds (64%) of the final sample, or 50% of the total if you include study dropouts.
Using the less strict outcome of symptom remission, 20 of the 22 participants met this criteria; that’s 91% of the final sample (71% of the total).
In total, nine participants were recovered and no longer receiving any kind of psychiatric treatment. That’s 64% of those who were recovered. And seven of those who recovered had also stopped taking antipsychotics (50%). Of the total sample, about a third (32%) had discontinued the drugs.
This, they write, “is consistent with evidence that there exists a subgroup … (20-40%) who can achieve recovery after several years without the need for continued antipsychotic medication.”
The researchers did float a few potential explanations for why their results seem better than other results from psychiatric care. For instance, they had a higher proportion of patients with more education (33% had finished high school), which could be a marker of symptoms developing later. They also write that Norway may promote more vocational and social opportunities than other countries, which could help enable self-efficacy, and thus promote success.
Researchers have increasingly identified childhood trauma as the primary cause of psychosis, even as biological theories involving dopamine and genetics have been debunked. This is consistent with previous studies that found that experiencing childhood trauma, not heritability, was associated with psychosis.
Thus, interventions that focus on healing from trauma and those that foster empathy, empowerment, and human connection—and respect those with lived experience—may be a more successful route to recovery.
As an alternative approach, research on Open Dialogue has demonstrated powerful outcomes unmatched by typical psychiatric treatment. Other alternatives, like Soteria houses and eCPR, could also provide peer-based care consistent with human rights—without the imprisonment and forced injections typical of modern psychiatry. These approaches are being tried all over the world, and even in small ways in the US. Yet these are the very interventions that are the least supported by funding from both US and international governments, with recent budget cuts decimating these programs.
****
Torgalsbøen, A.-K., Mohn, C., Larøi, F., & Czajkowski, N. (2025). Longitudinal recovery and self-efficacy in first-episode schizophrenia: Insights from a 10-year follow-up study. Front. Psychiatry, 16, 1588349. doi: 10.3389/fpsyt.2025.1588349 (Full text)
This article first appeared on Mad in America, original post here.