For schizophrenia, antidepressants reduces suicide rate

The use of antidepressive drugs for schizophrenia reduces the mortality rate. However, treatment with benzodiazepines increases it, especially the occurrence of suicide. Use of multiple antipsychotics seems to have no effect on mortality.

“We weren’t aware that the beneficial effects of antidepressives were so powerful,” revealed Jari Tiihonen, professor of clinical psychiatry at Karolinska Institutet’s Department of Clinical Neuroscience.

The study followed 2,588 Finns with schizophrenia an average of four years. On benzodiazepines, the patients ran a 91% higher risk of early death compared to when the drugs were not used.

“The increased suicide risk for patients with long-standing benzodiazepine use may be partly attributable to the possible development of withdrawal symptoms when the drugs run out,” explained Tiihonen. “These symptoms, which can be severe anxiety and insomnia, might have affected some of the patients’ decisions to commit suicide. It’s therefore extremely important that benzodiazepines are discontinued gradually rather than abruptly over a period of weeks or months and in consultation with a doctor.”

He continued, “The temporary acute use of benzodiazepines is justifiable if the patient is suffering a great deal of anxiety. But benzodiazepines should be discontinued within a month according to psychiatric recommendations, which doctors must start following and respecting.”

“People think that it’s dangerous to treat patients with schizophrenia with more than one antipsychotic drug, but there is nothing to back that up,” stated Tiihonen. Many doctors prescribe more than one drug hoping that two will work in combination. What Tiihonen suggests though is that increasing medications also increases adverse side effects which do impact health in the long run. He urges restraint.

Source: ScienceDaily, Karolinska Institutet