Too Many Schizophrenia Meds

Schizophrenia tends to be treated with multiple medications even though the cost can be deadly

(RxWiki News) Treating schizophrenia with benzodiazepines is not proving to have a great track record of success. Suicide and non-suicidal deaths both spike when there are benzodiazepines prescribed to schizophrenics.

A recent study looked at the mortality rates of different prescription drugs classes used to treat schizophrenia.

Dr. Jari Tiihonen MD., PhD., Chairman of the Department of Psychiatry at the University of Helsinki in Finland, led a study to evaluate risk factors for multiple medications taken by schizophrenics.

The researchers defined the problem: “More than 80 percent of all deaths occurred during treatment periods with prescriptions that included more than 28 [defined daily doses] of benzodiazepines, and more than 90 percent of patients used benzodiazepines on a long-term basis.

"Tell each of your doctors about all of your medications."

Such long-term use results in tolerance, dose escalation, and eventual withdrawal symptoms when the treatment medication is stopped abruptly, typically when the medication has run out before the next prescription is scheduled.” 

Often a mix of benzodiazepines, antidepressants and/or a antipsychotics can be hazardous to a patient’s health. Dr. Tiihonen’s team looked at the medication treatments of 2,588 schizophrenic patients with a first time diagnosis in the years between 2000-2007. The average follow up time period for the patients was 4.2 years.

The results showed that there was no difference in mortality rates for patients on one antipsychotic vs. two or more antipsychotics. Antidepressant use did not increase the risk of mortality, and also had lower suicide rates. Where the data really raises eyebrows is with the benzodiazepine drug class. Both for suicide and non-suicide benzodiazepine use resulted in higher death rates.

According to the study, “In total, 826 of 904 patients, 91.4 percent, of patients who used benzodiazepines had purchased prescriptions that contained more than 28 defined daily doses, violating treatment guidelines.”

160 of the original group died, 10 percent while in the hospital and 5 percent within 30 days of hospital release. Those patients treated with benzodiazepine had a 283 percent higher likelihood of committing suicide and a 60 percent increase in non-suicide deaths. These numbers reflect comparison to patients on antipsychotics or antidepressants.

Patients must fully disclose all of their medications, dosages and medication history to the doctor in order to play it safe. Findings support the use of antipsychotics and antidepressants and give cause for concern with benzodiazepine use.

This study was published in the Archives of General Psychiatry, May 2012. Funding fro this study was provided by annual Erityisvaltionosuus financing (special government subsidies from the Finnish Ministry of Social Affairs and Health) and by Janssen-Cilag. Financial disclosure is as follows: “Dr Tiihonen has served as a consultant to Lundbeck, Organon, Janssen-Cilag, Eli Lilly, AstraZeneca, F. Hoffman-La Roche, and Bristol-Myers Squibb and has received fees for giving expert opinions to Bristol-Myers Squibb and GlaxoSmithKline and lecture fees from Janssen-Cilag, Bristol-Myers Squibb, Eli Lilly, Pfizer, Lundbeck, GlaxoSmithKline, AstraZeneca, and Novartis.

Dr Suvisaari has served as a consultant to Janssen-Cilag and has received lecture fees from AstraZeneca. Dr Suokas has been in research collaboration with Janssen-Cilag. Dr Haukka has been in research collaboration with Janssen-Cilag and Eli Lilly and has been a member of the expert advisory group for Astellas.

Dr Korhonen has had research agreements with Janssen-Cilag, Novartis, Orion Pharma, Abbott, Novo Nordisk, Pfizer, and sanofi-aventis.”

Review Date: 
May 6, 2012