Reduserer bruken av antipsykotika mortaliteten ved schizofreni? En systematisk litteraturgjennomgang

Abstract

Background: This study explores the impact of antipsychotic medication on the overall mortality of individuals with schizophrenia. Antipsychotics have been a contentious topic since the 1950s, and recent efforts in Norway have also introduced medicine-free units as part of psychiatric treatment. While the protective role of antipsychotics against relapse is well-established, their effects on long-term outcomes and mortality remains debated. In this systematic review, we examined the literature with regards to how the use of antipsychotics affects all-cause mortality for people with schizophrenia. Methods: The researchers conducted a systematic search on PubMed, focusing on cohort studies, randomized clinical trials (RCTs), and case-control studies. Out of 899 identified articles, 52 initially met the criteria, but the scope was narrowed to include only meta-reviews. Ultimately, seven articles (five meta-reviews and two expert-provided articles) were considered. Results: Among the selected articles, one RCT-based review found no eligible studies. Four meta-reviews, largely based on cohort studies, revealed a significant and robust reduction in mortality among schizophrenic patients using antipsychotics compared to those not using them. Two meta-reviews, relying on RCTs, showed a non-significant trend favoring antipsychotics in lowering mortality. However, these two reviews had short follow-up periods, potentially explaining the lack of significant findings. Conclusion: The study suggests that antipsychotics substantially reduce mortality for individuals with schizophrenia, with a more pronounced effect observed in long-term studies than in short-term ones. Interestingly, cohort studies demonstrated a greater impact than RCTs, possibly due to confounding variables. The findings highlight the need for further research to explore factors contributing to mortality in this population.