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Cited by 224Schizophrenia research and treatmentMental Health and PsychiatryBipolar Disorder and Treatment

Influence of antipsychotics on mortality in schizophrenia: systematic review

Weinmann, Stefan, Read, John, Aderhold, Volkmar·2009·Schizophrenia Research
DOI 10.1016/j.schres.2009.05.018
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Abstract

Background Antipsychotic medication is the cornerstone of schizophrenia treatment. The impact of long-term exposure to antipsychotics on life-expectancy has recently received some attention, partly because awareness is increasing of the differential mortality of people with schizophrenia and the general population.Methods A systematic review of studies assessing the association between antipsychotic exposure and mortality in persons with schizophrenia was undertaken.Results In total, 12 studies met the inclusion criteria. Three out of five studies examining antipsychotic dosage and higher mortality showed a significant association for one or more antipsychotics. Two out of four found negative effects of antipsychotic polypharmacy on life-expectancy. Some studies found a lower cardiovascular mortality risk with higher treatment intensity or when comparing current versus past or non-use of antipsychotics. Others established a stable correlation between antipsychotic exposure and an increase in cardiovascular mortality. Evidence for differential effects on mortality in favor of second generation (SGA) compared to first generation antipsychotics was inconsistent. No study of SGA drugs had a sufficient follow-up time. A major confounding factor may be a higher risk factor load for somatic disorders in the most severely mentally ill.Conclusion There is some evidence that long-term exposure to antipsychotics increases mortality in schizophrenia. More rigorously designed, prospective studies are urgently needed.

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Crossref · 10.1016/j.schres.2009.05.018

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  • Death rates are increased in people with severe mental illness (SMI) relative to the general population, reflected in the 10- to 20-year reduced life expectancy observed.

    “Death rates are increased in people with severe mental illness (SMI) relative to the general population, and this is reflected in the 10- to 20-year reduced life expectancy observed.1–3”

    From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [3]

  • A longer time to remission likely involves prolonged periods and higher dose of exposure to antipsychotic medication, which have been posited to increase natural-cause mortality via metabolic mechanisms.

    “a longer time to remission is likely to involve prolonged periods (and higher dose) of exposure to antipsychotic medication, which have been posited to increase natural-cause mortality via metabolic mechanisms.46–48”

    From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [48]

  • Findings on the association between exposure to antipsychotic medication and natural-cause mortality remain inconsistent.

    “overall, findings on the association between exposure to antipsychotic medication and natural-cause mortality remain inconsistent.2,48,49”

    From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [48]

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Authors
Weinmann, S., Read, J., & Aderhold, V.
Affiliations
  • Charité – Universitätsmedizin Berlin (DE)
  • University of Auckland (NZ)
  • Universität Greifswald (DE)
Corresponding author
Weinmann, Stefan
ORCID
Venue
Schizophrenia Research
Publisher
Elsevier BV
Published
2009-08
Volume
113
Issue
1
Pages
1-11
ISSN
0920-9964 (ISSN-L)
DOI
10.1016/j.schres.2009.05.018
OpenAlex
W2039802122
Cited by
224
References
45
Citations by year
2026: 1 · 2025: 3 · 2024: 5 · 2023: 1 · 2022: 10 · 2021: 10 · 2020: 7 · 2019: 14 · 2018: 12 · 2017: 12 · 2016: 17 · 2015: 18 · 2014: 23 · 2013: 18 · 2012: 16
FWCI
3.05
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Schizophrenia Research (publishedVersion)
  • PubMed (publishedVersion)
  • Swinburne figshare (Swinburne University of Technology) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
antipsychotic drugs, schizophrenia
MeSH terms
Humans, Schizophrenia, Antipsychotic Agents, Databases, Factual

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