Antipsychotic Treatment and Mortality in Schizophrenia: No Drugs = Higher Mortality

Good news for most of the people here: (I know that Firemonkey posted this before - I just wanted to draw attention to it, and the Pubmed reference).


Among patients with schizophrenia, the cumulative antipsychotic exposure displays a U-shaped curve for overall mortality, revealing the highest risk of death among those patients with no antipsychotic use.

These results indicate that both excess overall and cardiovascular mortality in schizophrenia is attributable to other factors than antipsychotic treatment when used in adequate dosages.


I wonder also if going off and on the meds is hard on the system?
What is the alternative???**

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Yeah I wonder too?

One I noticed is going on off meds (risperdal) make me more susceptible to dystonia+parkinson side-effects whenever I resume.

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It would be interesting to know who these people work for, who pays them, and what controls they actually used in these studies…

We can also look at the flip side:

While I strongly appreciate the link to an alternate point of view, I would try to not let that link scare me too much without looking into it more deeply. For instance, one study is quoted as saying that a certain, seemingly shocking, percentage of patients on antipsychotics in a sample died during a decade; but, if you dig into the article (which to the credit of the web site, is provided) you can clearly see that the average (mean) age of the sample was 62.5 years, and these were, apparently, all patients who were symptomatic enough to be in a long term psychiatric care facility.

It reminds me a lot of a news article online, with a scary, sensationalistic title, but then you dig into it more deeply and say to yourself “Whew! So THAT is what they meant!”

Just my 2 cents.


Do anti-psychotics cause dementia later on? I know that the black box warning indicates not helpful for people with dementia related psychosis. Is that instead saying that it doesn’t work for them or do the medications actually impair memory?

I can see reasons why longer life can be seen with anti-psychotics: they often prevent suicide and correct psychosis, but is diabetes and other issues related to schizophrenia or the medication?

But that statistic makes me confident more in taking medication.

Well I am on meds now, but I have to have a long term plan.
I will be seeing my psychiatrist next week, I think she wants me on Risperdal but at a very low dose - she does not want to risk my current stability on introducing a new antipsychotic to the picture.

I don’t know how healthy 1 mg of Risperdal would be to my system, if I can lose weight and such a low dose does not harm me physically, I will continue to remain on a very low dose of Risperdal, but i doubt that this will be the case, and I don’t think that she will allow me to go antipsychotic free so I have to go and risk it all on a new antipsychotic - one with a good metabolic profile

The warning is due to major complications when giving APs to people with dementia.
However, Haldol is known through studies to cause brain shrinkage…so i would imagine at least with that med dementia could be a possible outcome later on.
Other studies show that Zyprexa (olanzapine) also causes brain mass loss.

There is no scientific evidence that AP’s cause dementia - not at least that I know of


In more details.

To investigate this hypothesis in a rigorous, prospective setting, Jari Tiihonen (Karolinska Institute, Stockholm) and colleagues undertook a population-based cohort study of all 21,492 people aged 17–65 years in Sweden diagnosed with schizophrenia before 2006.

In order to avoid survival bias, they also conducted an analysis in a separate cohort of 1230 patients with first-episode schizophrenia during the period 2006–2010. A total of 214,670 age- and gender-matched individuals from the general population served as controls.

The schizophrenia patients were assessed for cumulative exposure to antipsychotic drugs by defined daily dose (DDD) and categorised into four groups: no antipsychotics; small doses or occasional use (0–0.5 DDD/day); moderate doses (0.5–1.5 DDD); and high doses (>1.5 DDD/day).

In total, 1591 (7%) people in the main cohort died during 5 years of follow-up while 45 (4%) of those with first-episode schizophrenia died.

Mortality rates differed among the four antipsychotic exposure groups and displayed a U-shape curve, Tiihonen and co-workers report in Schizophrenia Bulletin. Compared with the general population, hazard ratios (HRs) for overall mortality were 6.3 for no antipsychotic use, 5.7 for high antipsychotic use, and 4.1 and 4.0 for low and moderate antipsychotic use, respectively.