So, I had a meaningful, intelligent conversation with my pdoc today about medication. Toward the end of the conversation, he claimed (again) that he had a schizophrenic patient with a PhD whose IQ at one point tested at 138 (because he had applied for mensa), but after refusing meds for 20 years, his IQ apparently plummeted to 86 (or so that was the value when he was retested).

I think 86 is not too far above the threshold for mental retardation, is it not? Or at least it’s below average. And if my pdoc’s word is anything to go by, I’m guessing at some point you would become “mentally retarded,” or so to speak, if you kept refusing meds. To me, that sounds a little odd and difficult to believe.

Is this actually a thing that happens, or do you think this is just another scare tactic? I have never heard of such a thing happening. However, I am not discounting it because I just don’t know. I’m not an expert in the field of psychiatry and don’t claim to be.

[Blue_Bird]

I don't know about it but it Probably depends on the illness, severity, and person. And Lots of different factors would go into it

[Blue_Bird]

I know psychosis can screw up cognitive abilities over time , I don't think that's the same as changing a person's IQ that drastically though. I've never heard of that happening but who knows

Originally Posted by Blue_Bird

I don't know about it but it Probably depends on the illness, severity, and person. And Lots of different factors would go into it

Yes, I assume that would be the case if it were true. However, I was wondering if such a thing could possibly happen. Like, if there are any medical research studies out there that have proven this can occur.

[Wild Coyote]

I wonder if the decrease in IQ had anything to do with the lack of medication compliance? I wonder how he could conclude the patient's mental decline was due to a lack of medication?

One anecdotal account doesn't substantiate any conclusion.

If there is more information, stating the same, that may be different.

Love to All ~

[Nammu]

Psychotic episodes are hard on the brain and I've heard that it causes cognitive issues. To me it's really a case of damned if you do and damned if you don't. For me I've chosen the meds cause life is overall better on then than off them. I could be hit by a car tomorrow so why worry about the nebulous possible effects of a med when my life is so much smoother on that med. the meds that did me the most harm were AD and benzos as both cause mood instability. That effect was clear and noticeable stopping them was a clear benefit. With AP the clear benefit is a much more stable day to day life. Yes there's a possibility future side effects but for now the benefit outweighs risk.

[fern46]

I've actually heard taking APs drops your IQ a few points over time. I'll deal with it though to avoid psychosis.

[wiretwister]

after nearly 7 years of meds I feel I am much "slower" , is it the bp , the meds , or just my stress and age (62) now . . . I have no idea . . . but I am very calm . . . I guess a fair trade off . .
love . . Tigger

[~Christina]

Good question Blue ....something to certainly think about.

Some studies show repeated untreated manic episodes will chip away at your IQ which I do believe is true

Low term psych Med use has shown potential for causing loss of cognitive abilities and decrease in IQ which I also believe is true.

So really a person has to decide what’s best for them in the say next 5 years ??? If meds help you function better, enjoy life and activities keep away paranoia etc . Then ..... Yes I think Meds would be worth it.

New meds are always being released, it’s likely all the new meds coming out won’t have the possibility of long term cognitive problems.

[Scooter9]

Just do a Google search for "mania grey matter" or "bipolar grey matter" and you'll find lots about how episodes cause the loss of grey matter, the stuff our brain is made of.

Then search for "bipolar neuroprotective" for articles about how lithium protects the brain. That's just lithium but maybe some more digging will turn up something about the benefits of other meds.

I think my memory issues are a result of my depression, also based on what my doctors have told me over the years, and I'm hoping that once I find a combo that works I'll at least stop the loss of memory.

Having been on meds for years, I haven't lost any of my intelligence though.

I hope you find information that helps you blue.

[still_crazy]

hi. i...don't want to call your psychiatrist a 'liar,' but...if the IQ dropped to 86, I think there's something besides Schizophrenia going on there. Maybe...

if they were refusing meds, ended up hospitalized and drugged to the gills, perhaps some shock treatments, then they were released and went off the meds again (vicious cycle)...

I could see that pattern resulting in loss of IQ, especially with the doses of the old drugs that were once popular in hospital settings (1500mgs/Thorazine was not unheard of...).

[MobiusPsyche]

That score is still a long way from the cutoff for intellectual disabilities. The cutoff is 70, the standard deviation is 15, so it's still quite a ways off.

Yes, cognitive decline can be a symptom/result of schizophrenia.

Originally Posted by still_crazy

hi. i...don't want to call your psychiatrist a 'liar,' but...if the IQ dropped to 86, I think there's something besides Schizophrenia going on there. Maybe...

if they were refusing meds, ended up hospitalized and drugged to the gills, perhaps some shock treatments, then they were released and went off the meds again (vicious cycle)...

I could see that pattern resulting in loss of IQ, especially with the doses of the old drugs that were once popular in hospital settings (1500mgs/Thorazine was not unheard of...).

That's what I was thinking, drugs (recreational or prescription), maybe a TBI (or several) along the way? Who knows what your pdoc could be leaving out without technically lying.

Although I have heard of repeated psychosis/mania damaging the brain too, but that IQ drop seems a little excessive to go from gifted to below average in 20 years just from psychosis. I'm not saying it can't happen (I really don't know), but I agree, there was probably something left out or exaggerated.

[fern46]

I also wonder how accurate an IQ test would be of someone who is in the middle of a schizophrenic episode. Their brain is not able to process thought correctly in that state and they can be highly disorganized. Perhaps the patient was exhibiting more symptoms when the test was administered the second time. I imagine the numbers might go back up if the patient were stable. Stability may require medication which somewhat validates the psychiatrist's point, but if this is the case it doesn't prove the lack of medication caused a permanent cognitive deficiency.

[still_crazy]

i agree with another poster...if this individual has been dealing with full on Schizophrenia without long term treatment, any IQ estimate is going to be off base until they've been stabilized for a while.

it is worth noting that high doses of the older drugs (in particular) were/are linked to "tardive dementia," a measurable loss of intellectual capacity. many people with tardive dyskinesia also have varying degrees of loss of IQ, which is why some 'experts' think/thought of TD as a 'dementing disorder' (I don't know if this applies with atypicals...TD is less frequent and usually less severe than with, say, long term, high dose Prolixin).

and...you know how mothers are notorious, as a group, for making up frightening tales to scare young children into compliance? yeah...I think this tale of woe follows the same sort of theme... :-)

...and if he didn't take meds, why was he seeing a psychiatrist for 20 years?

[Sometimes psychotic]

I think it could happen but IQ is complex and only certain areas get targeted by illness for example working memory...my main question was whether there was comorbid illegal drug use in this patient but I will say I’ve lost 20 IQ points in working memory and 30 in processing speed since my first psychosis it just seems that some 50-60 points is a ton and I hope it’s untrue.

Originally Posted by spikes

...and if he didn't take meds, why was he seeing a psychiatrist for 20 years?

Lol, good question!

The story seems shaky/incomplete to me. If it actually happened (*that* dramatically) I think there would be more to the story -- like additional factors, as others have suggested. So, I'm skeptical, but I don't even play a doctor on tv.

[*Beth*]

What an intriguing thread this is!


Of course, I don't have an informed answer about the man's IQ plummet, but I'm sure interested in learning more about it. I'm putting this on my "research this question" list.

Originally Posted by Innerzone

Lol, good question!

The story seems shaky/incomplete to me. If it actually happened (*that* dramatically) I think there would be more to the story -- like additional factors, as others have suggested. So, I'm skeptical, but I don't even play a doctor on tv.

I don't know about the whole "20 years" thing because I didn't clarify with my pdoc, but I wonder if my pdoc meant that the guy kept refusing to see a psychiatrist for 20+ years. Not like what spikes was suggesting where he was seeing one for 20 years and kept refusing meds. But who knows. Maybe the guy *was* seeing a pdoc for 20 years.

It is possible that my pdoc grossly exaggerated the IQ reduction -- I don't know -- but I don't know enough about antipsychotic use vs the kindling theory to actually know whether or not this is even possible. From the brief research I did, though, I saw measured data on grey matter destruction from antipsychotics (particularly first gens, but some second gens too) via MRI analysis. Such studies suggested that the grey matter reduction from long-term antipsychotic use was worse than what would happen if you didn't take antipsychotics at all. Said study was conducted over the course of 20 years, while nearly every other study spanned 3 years at most. However, the whole "this schizophrenic guy's IQ reduced by like 50 billion points" was my pdoc's counter argument, and I couldn't find any evidence of a "significant" IQ reduction. I'm not denying that untreated Sz causes brain damage, but I couldn't find anything with regards to a significant IQ drop to the brink of mental retardation.

[fern46]

Originally Posted by bluebicycle

I don't know about the whole "20 years" thing because I didn't clarify with my pdoc, but I wonder if my pdoc meant that the guy kept refusing to see a psychiatrist for 20+ years. Not like what spikes was suggesting where he was seeing one for 20 years and kept refusing meds. But who knows. Maybe the guy *was* seeing a pdoc for 20 years.

It is possible that my pdoc grossly exaggerated the IQ reduction -- I don't know -- but I don't know enough about antipsychotic use vs the kindling theory to actually know whether or not this is even possible. From the brief research I did, though, I saw measured data on grey matter destruction from antipsychotics (particularly first gens, but some second gens too) via MRI analysis. Such studies suggested that the grey matter reduction from long-term antipsychotic use was worse than what would happen if you didn't take antipsychotics at all. Said study was conducted over the course of 20 years, while nearly every other study spanned 3 years at most. However, the whole "this schizophrenic guy's IQ reduced by like 50 billion points" was my pdoc's counter argument, and I couldn't find any evidence of a "significant" IQ reduction. I'm not denying that untreated Sz causes brain damage, but I couldn't find anything with regards to a significant IQ drop to the brink of mental retardation.

Assuming someone has schizophrenia and refuses meds they are also probably not likely candidates to participate in research studies where they receive comparative MRIs. It stinks there is such a lack of data in this arena. The sad truth is pdocs are flying partially blind and a lot of what they do is guess work.