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

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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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Authors: Weinmann, S., Read, J., & Aderhold, V.
Affiliations: Charité – Universitätsmedizin Berlin (DE)
University of Auckland (NZ)
Universität Greifswald (DE)
Corresponding author: Weinmann, Stefan
ORCID: Weinmann, Stefan
Read, John
Aderhold, Volkmar
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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Influence of antipsychotics on mortality in schizophrenia: Systematic review

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