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Viewpoint: do antipsychotics protect against early death? A critical view

Published online by Cambridge University Press:  14 October 2020

Robert Whitaker Open the ORCID record for Robert Whitaker [Opens in a new window]
Robert Whitaker*
Affiliation:
Mad in America Foundation, 02139Cambridge, MA, USA
*
Author for correspondence: Robert Whitaker, E-mail: rwhitaker@madinamerica.com
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Abstract

In the past 15 years, researchers utilizing prescription databases to assess medication usage have concluded that antipsychotics reduce mortality in patients diagnosed with schizophrenia and other psychotic disorders. These findings stand in contrast to studies in non-psychiatric patients that have found that antipsychotics, because of their adverse effects on physical health, increase the risk of early death. A critical review of the evidence reveals that the worry remains. There is reason to conclude that antipsychotics contribute to the ‘mortality gap’ between the seriously mentally ill and the general population and that the database studies are plagued with methodological and reporting issues. Most importantly, the database studies tell of mortality rates within a drug-centered paradigm of care, which confounds any comparison of mortality risks when patients are on or off antipsychotics.

Keywords

Antipsychoticsmortalityschizophreniaseriously mentally ill
Type
Invited Review
Information
Psychological Medicine , Volume 50 , Issue 16 , December 2020 , pp. 2643 - 2652
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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