How Do Antipsychotics Affect Mortality Risk in Schizophrenia Patients?

Long-acting injection (LAI) use is associated with an approximately 30% lower risk of death than the use of oral agents in patients with schizophrenia, according to the results of a recent study.

Whether antipsychotic treatment among patients with schizophrenia is associated with an increase or decrease in mortality risk is controversial. The effects of specific agents or routes on this association are also unknown.
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For their study, researchers examined data on 29,823 patients with schizophrenia in Sweden, aged 16 to 64 years.

During a mean follow-up of 5.7 years, 2515 (8.4% of the patients died. Over 7.5 years, second generation (SG) LAI use was associated with the lowest cumulative mortality (7.5%). Adjusted hazard ratios (HRs) compared with SG LAI use were 1.37 for first generation (FG) LAI, 1.52 for SG oral treatments, 1.83 for FG oral treatments, and 3.39 for use of no antipsychotics.

The lowest mortality was observed with use of once-monthly paliperidone LAI, oral aripiprazole, and risperidone LAI. In pairwise comparison, LAIs were associated with 33% lower mortality than equivalent oral agents.

“Mortality among patients with schizophrenia is over 40% lower during those time periods when the patients use antipsychotics than when they do not. LAI use is associated with an approximately 30% lower risk of death compared with the oral use of the same medication. SG LAIs and oral aripiprazole are associated with the lowest mortality.”

—Michael Potts

Reference:

Taipale H, Mittendorfer-Rutz E, Alexanderson K, et al. Antipsychotics and mortality in a nationwide cohort of 29,823 patients with schizophrenia [published online December 20, 2017]. Schizophrenia Research. http://dx.doi.org/10.1016/j.schres.2017.12.010