Long-term effects of antipsychotics on mortality in patients with schizophrenia: a systematic review and meta-analysis
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
; 44(6): 664-673, Nov.-Dec. 2022. tab, graf
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1420533
Responsible library:
BR1.1
ABSTRACT
Objective:
To gather current evidence on the impact of antipsychotics on long-term mortality in patients with schizophrenia.Methods:
We systematically searched for articles in Embase, PubMed, and PsycINFO reporting the long-term mortality (follow-up > 1 year) of patients with schizophrenia who were using any antipsychotics. We then conducted multiple meta-analyses to determine differences in long-term mortality between different types of antipsychotics.Results:
We identified 45 articles that provided unadjusted long-term mortality rates, including 46,171 deaths during 2,394,911 person-years. The pooled mortality rate was 9.9 (95%CI = 7.4-12.7) per 1,000 person-years. The unadjusted crude mortality rate of antipsychotic drug users was lower than that of non-users (risk ratio [RR] = 0.546, 95%CI = 0.480-0.621), first-generation antipsychotics caused higher all-cause mortality than second-generation antipsychotics (RR = 1.485, 95%CI = 1.361-1.620), and polypharmacy had better effects than monotherapy on long-term mortality (RR = 0.796, 95%CI = 0.689-0.921). As for the causes of death, heart disease and cardiovascular disease ranked highest among cause-specific mortality (5.6 per 1,000 person-years).Conclusion:
Since antipsychotics had a beneficial effect on long-term mortality in schizophrenia, greater precaution should be taken with patients who do not take them. However, since disease severity, comorbidities, and other confounding factors cannot be fully controlled, further research and verification are needed.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Mental Health and Behavioral Disorders
Database:
LILACS
Type of study:
Prognostic study
/
Systematic review
Language:
English
Journal:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Journal subject:
Psychiatry
Year:
2022
Document type:
Article
/
Project document
Affiliation country:
China
Institution/Affiliation country:
Jilin University/CN