Good news for people with schizophrenia: Long-term antipsychotic-drug treatment does not increase the risk of heart disease. And taking the drugs is associated with a lower risk of death, according to a new study.
The average life expectancy of people with schizophrenia is 10 to 20 years less than in the general population. There has long been concern that one reason is long-term use of antipsychotic drugs to ease symptoms such as delusions and hallucinations.
"Antipsychotics get something of a bad press, which can make it difficult to reach out to the patient group with information on how important they are," said study co-author Jari Tiihonen, a professor of psychiatry at Karolinska Institute in Sweden.
"We know from previous studies that only half of those who have been discharged from hospital after their first psychotic episode with a schizophrenia diagnosis take antipsychotic drugs," Tiihonen added in an institute news release.
Previous studies found that the death rate among people with schizophrenia on antipsychotic medications was 30 percent to 50 percent lower than among those who took a placebo.
But most of the studies were shorter than six months, which does not reflect the fact that antipsychotic treatment is often lifelong, the study authors noted.
The new study included more than 62,000 people in Finland who had received a schizophrenia diagnosis at some time between 1972 and 2014. They were followed for an average of more than 14 years.
The chances of being hospitalized for physical conditions such as heart disease were just as high when the patients were on antipsychotic drugs as when they weren't.
However, cumulative death rates during the follow-up were 26 percent when patients were taking antipsychotics and 46 percent when they weren't taking the drugs, according to the study.
Instead of taking recommended antipsychotics, Tiihonen said many people with schizophrenia are on long-term benzodiazepine medication, which is in breach of existing guidelines and is associated with increased mortality risk. Benzodiazepines, which include Valium and Xanax, are typically tranquilizers.
"Building trust and understanding towards the efficacy and safety of antipsychotic drugs is important, and we hope that this study can contribute to this end," Tiihonen said.
Antipsychotic drugs include older medications like Haldol (haloperidol) and Thorazine (chlorpromazine). Newer ones are called atypicals, and include Abilify (aripiprazole) and Zyprexa (olanzapine).
Because antipsychotics are associated with weight gain, it was thought they might raise the risk of heart disease.
But the researchers noted they may reduce high blood pressure, quell anxiety and the risk for substance abuse, and lead patients toward a healthier lifestyle.
The study was published recently in the journal World Psychiatry.
The U.S. National Institute of Mental Health has more on schizophrenia.
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