Schizophrenia Patients Who Take Antipsychotics Live Longer, Study Says

Exception was patients on high doses of first-generation drugs

By Robert Preidt

Wednesday, November 14, 2012

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WEDNESDAY, Nov. 14 (HealthDay News) -- People with schizophrenia are likely to live longer if they take their antipsychotic drugs on schedule, avoid extremely high doses and have regular visits with a mental-health professional, according to a new study.
It's long been known that adhering to a drug regimen reduces the number of the delusions and hallucinations experienced by schizophrenia patients, but there have been concerns that known physical side effects of the medications -- such as diabetes and heart disease -- might increase the risk of death.
In this study, researchers analyzed data collected from 1994 to 2004 on more than 2,100 adult schizophrenia patients in Maryland. The most common cause of death was cardiovascular disease, which was responsible for 28 percent of patient deaths. Unintended harm, in which researchers included suicide, caused 8 percent of patient deaths during the study period.
Patients with a 90 percent or better compliance with their antipsychotic medication regimen had a 25 percent lower risk of death than those with a compliance of less than 10 percent.
The researchers also found that each additional visit per year to a mental-health professional was associated with a 5 percent reduction in overall death risk.
Although sticking with an antipsychotic drug regimen reduced the risk of death, the researchers found that patients who took high doses of first-generation antipsychotics daily had an 88 percent increased risk of death.
First-generation antipsychotics have been linked with heart disease risks, and among the patients who died in the study while taking larger doses, 53 percent died of cardiovascular disease.
"These drugs work very well, but there is clearly a point of diminishing returns. You rarely need to be on extremely high doses," study leader Bernadette Cullen, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, in Baltimore, said in a university news release.
The study was published online Oct. 30 in the journal Schizophrenia Bulletin.
"We know that antipsychotic medications reduce symptoms, and our study shows that staying on reasonable, recommended doses is associated with longer life," Cullen said. "The same is true for going to see a psychiatrist or therapist."
Cullen noted that regular visits to a mental-health professional are one way to monitor and encourage drug-use compliance, but also in and of themselves increase survival among schizophrenia patients.
"If people are taking their medications, they usually have fewer symptoms and are able to be more organized in other areas of their lives," said Cullen, who also is director of community psychiatry at the Johns Hopkins Hospital.
"We believe they are then more likely to make appointments with their primary care doctors, to stay on top of other illnesses they may have and to regularly take diabetes, blood pressure or cholesterol medication that they may require to stay healthy," she said. "We also believe that they are more likely to be socially engaged and have a healthier lifestyle."
Although the researchers found an association between strict antipsychotic drug regimens and longer life among people with schizophrenia, they did not prove a cause-and-effect relationship.

SOURCE: Johns Hopkins Medicine, news release, November 2012

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