Study: Low-dose antipsychotics and regular mental health visits extend life expectancy of schizophrenics

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People with schizophrenia are likely to live a significantly longer life if they take lower levels of antipsychotic drugs and see a mental health professional, Johns Hopkins researchers say.

Investigators discovered that in patients who had 90% or better compliance with their medication schedules, the risk of death was 25% lower, compared to those who were less than 10% compliant. They also noted that taking medication did not increase the risk of death and there was a trend toward reducing the mortality rate.

While it's accepted that people with schizophrenia who stick to a drug regimen have fewer delusions and hallucinations, there are worries about known side effects of medications, which include increased cardiovascular disease and diabetes, and higher mortality risks.

"We know that antipsychotic medications reduce symptoms, and our study shows that staying on reasonable, recommended doses is associated with longer life," says Bernadette A. Cullen, M.B., B.Ch., B.A.O., MRCPsych, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, and leader of the study published in Schizophrenia Bulletin. "The same is true for going to see a psychiatrist or therapist,” who can additionally monitor and encourage medication compliance.

Cullen and colleagues analyzed data collected between 1994 through 2004 on 2,100 adult Maryland Medicaid beneficiaries with schizophrenia. The researchers reviewed adherence to the 2009 pharmacological Schizophrenia Patient Outcomes Research Team (PORT) guidelines associated with mortality in this population.

Cullen says the study clearly lays out the value of mental health providers to individuals with schizophrenia. Those who saw therapists or psychiatrists were more likely to survive, regardless of whether the individual also took his or her antipsychotic medication on a regular basis, she says.

This finding is crucial, she says, given that Maryland Medicaid officials are considering capping the number of mental health visits allowed each year, something the data now suggest is potentially detrimental to survival.