How is mortality related to antipsychotic use?

Compared to the general population, on average, the life expectancy of people with schizophrenia may be reduced by as much as 15-20 year. The reasons for increased mortality in schizophrenia are largely unclear, but may in part be related to lifestyle factors such as weight gain, smoking, unhealthy diet and low physical activity levels. Adverse effects of antipsychotics may also contribute to high mortality rates in schizophrenia.

What is the evidence for mortality as a side effect of antipsychotic medication?

Moderate to high quality evidence suggests a medium-sized effect of fewer deaths in people with schizophrenia taking any antipsychotic than in people with schizophrenia not taking antipsychotics.

Moderate quality evidence suggests no differences in all-cause mortality or suicide rates between people with schizophrenia who are on long-acting injectable antipsychotics, oral antipsychotics or placebo. There were no significant differences in rates according to antipsychotic type (first vs. second generation), study duration, industry vs. non-industry trials, illness status (acute vs. other), or antipsychotic dose.

Moderate to high quality evidence suggests the mortality rate in people taking clozapine over the long-term is 6.7, which is lower than for patients taking other antipsychotics.

October 2020

Last updated at: 10:23 pm, 19th October 2020
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