Drugs that treat psychiatric illnesses may not increase a
person's risk of dying over three to four months of treatment, according to a
Researchers found people with mental illnesses such as
schizophrenia and bipolar disorder are more likely to die at any given time
than people without those conditions, but taking drugs to treat the disorders
doesn't appear to increase that risk.
"If anything they seem to reduce the risk except for a
couple of old drugs," Dr Arif Khan, the study's lead author from the
Northwest Clinical Research Center in Bellevue, Washington, told Reuters
For many years, researchers and doctors have known the lives
of people with serious mental illnesses are about 25 years shorter than the
rest of the population, on average.
Their earlier deaths are caused by a combination of
suicides, substance abuse and natural causes, such as heart attacks. There had
been lingering concerns, however, that drugs used to treat psychiatric
conditions may contribute to early deaths.
For the new study, the researchers analysed data on more
than 92 000 people who participated in trials for 28 drugs approved for the
treatment of schizophrenia, depression, bipolar disorder, anxiety disorders and
attention-deficit/hyperactivity disorder between 1990 and 2011.
Their goal was to see whether people with psychiatric
illnesses have higher death rates than people in the general population and
whether taking medication increases that risk.
Khan and his colleagues said the overall US death rate for
people between the ages of 20 and 65 years old was 331 per 100 000 people
around the year 2000.Compared to the general population, the researchers found
people with schizophrenia were almost four times more likely to die every year
and people with bipolar disorder and depression were about three times more
likely to die every year.
The researchers could not evaluate whether death rates
differed among people with anxiety disorders, because so few deaths were
recorded during the trials.
They did find, however, that people's risk of dying
decreased when they were randomly assigned to take medications to treat their
psychiatric disorders – such as antipsychotics for schizophrenia and mood
stabilisers for bipolar disorder – compared to those who were assigned to take
a drug-free placebo.
Suicide accounted for just over 40% of deaths in all
patients across drug trials. Khan said the researchers aren't sure why the
drugs appeared to decrease patients' risk of dying, but the finding should be
reassuring for doctors. "For practicing clinicians, they should feel
comfortable that they can prescribe these medications," he said.
The exception to the lower death rates was a class of older
antidepressants known as heterocyclics, which include tricyclic and tetracyclic
antidepressants. Those were linked to about a doubling in risk, but the drugs
have been largely replaced by newer medications.The researchers write in JAMA Psychiatry that more research
is needed to confirm their findings, because the data they used were limited
and not initially collected to evaluate death risks. Also, more data are needed
on the risks of taking the drugs for more than a few months.
Dr Timothy Lineberry, a psychiatrist at the Mayo Clinic in
Rochester, Minnesota, told Reuters Health it's also important to remember that
the patients included in these trials were receiving regular care and being
"The issue is still that the overall mortality was high
and specific to the different types of psychiatric illness," Lineberry,
who wasn't involved with the new study, said."We need to understand and
come up with strategies... to improve and reduce mortality associated with
psychiatric illnesses," he said.