Researchers at Karolinska Institute in Sweden and their colleagues in Germany, the United States, and France have studied the safety of a very long-term antipsychotic therapy for schizophrenia in the largest conducted analysis in the field to date.

Many of the studies conducted previously have been shorter than 6 months. A long-term, follow-up substantiating previous results demonstrated that antipsychotic drugs are not associated with increased risk of comorbid complications.

More than 62,000 Finns who had received a schizophrenia diagnosis between 1972 and 2014 were monitored by accessing various Finnish registries up until 2015.

The researchers found that the likelihood of being hospitalized for a somatic disease was just as high during the periods when the patients were on antipsychotic drugs as when they were not; however, the differences in mortality were clear.

The cumulative mortality rate in the follow-up period at times of medication and non-medication was 26% and 46%, respectively.

Although the researchers believe a continual antipsychotic treatment for schizophrenia is safer than no medication, there is a risk of adverse reactions, such as increases in weight and the risk of cardiovascular disease.

In addition, the study authors argue that treatment with antipsychotic drugs does not increase the likelihood of hospitalization for cardiovascular disease, and it is possibly attributable to the fact that the drugs can also have an antihypertensive effect, such as reducing anxiety and the risk of substance abuse.  

"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 Jari Tiihonen, professor of psychiatry at the Department of Clinical Neuroscience, Karolinska Institutet, in a press release. "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. Besides, there are many people with schizophrenia who are on long-term benzodiazepine medication, which is in breach of existing guidelines and is associated with increased mortality risk. 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."


Long-term medication for schizophrenia is safe, study suggests. ScienceDaily. Published January 10, 2020. Accessed January 15, 2020.