Neuroleptics and mortality in schizophrenia: prospective analysis of deaths in a French cohort of schizophrenic patients

Montout, Christine; Casadebaig, F.; Lagnaoui, Rajaa; Verdoux, Hélène; Philippe, A.; Bégaud, Bernard; Moore, Nicholas

doi:10.1016/s0920-9964(01)00325-5

Cited by 66 publications

(26 citation statements)

References 21 publications

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“…Evidence that older, typical neuroleptic drugs, alone or with antidepressants added, alter suicidal risks in schizophrenia patients, either favorably or unfavorably, is limited and inconsistent [8,12,13,14]. Risk of mortality due to natural causes, including sudden death presumably related to cardiac dysfunction, may be increased with older neuroleptics as well as with modern atypical or second-generation antipsychotics (SGAs) [15,16]. Compelling evidence for the protective or antisuicidal effects of older neuroleptics is lacking, and they have effects that might increase suicidal risk.…”

Section: Resultsmentioning

confidence: 99%

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Pompili

Baldessarini

Forte

et al. 2016

IJMS

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Modern antipsychotic drugs are employed increasingly in the treatment of mood disorders as well as psychoses, stimulating interest in their possible contributions to altering suicidal risk. Clozapine remains the only treatment with an FDA-recognized indication for reducing suicidal risk (in schizophrenia). We carried out a systematic, computerized search for reports of studies involving antipsychotic drug treatment and suicidal behaviors. A total of 19 reports provide data with preliminary support for potential suicide risk-reducing effects of olanzapine, quetiapine, ziprasidone, aripiprazole, and asenapine in addition to clozapine, and provide some support for antipsychotic drug treatment in general. These preliminary findings encourage further testing of antipsychotics for effects on suicidal behavior, making use of explicit, pre-planned assessments of suicidal behavior.

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Section: Resultsmentioning

confidence: 99%

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Pompili

Baldessarini

Forte

et al. 2016

IJMS

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“…86 These findings contrast with two other studies reporting a decreased suicide risk with the thioxanthenes-zuclopenthixol (versus haloperidol) 87 and flupenthixol (versus placebo). 88 An increased suicide risk among users of thioxanthenes may reflect the greater use of this neuroleptic in depressed patients.…”

Section: Conventional Antipsychoticsmentioning

confidence: 76%

“…Consequently, clinicians might preferentially prescribe them for depressed or suicidal schizophrenia patients. 86 Notably, about 20% of patients in the study by Montout and colleagues 86 also took antidepressants, and approximately three-quarters took other psychotropic drugs. None of these cotreatments was statistically controlled for in comparisons of patients taking thioxanthenes versus other neuroleptics.…”

Section: Conventional Antipsychoticsmentioning

confidence: 96%

Antisuicide Properties of Psychotropic Drugs: A Critical Review

Ernst

Goldberg

2004

Harvard Review of Psychiatry

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The authors consider the extent to which psychotropic medications demonstrate benefits in the prevention of suicidal behavior in psychiatric patients. Results of a MedLine search are critically reviewed for lithium, divalproex and other anticonvulsants, conventional and atypical antipsychotics, and antidepressants. The existing literature is almost entirely limited to noncontrolled, often retrospective studies that do not control for potential biases in treatment selection, the use of multiple medications, the impact of medication nonadherence, and nonrandomized treatment discontinuations. Nevertheless, an extensive literature has arisen regarding observed reductions in suicidal behavior with lithium for mood disorders and, to a lesser extent, with clozapine for schizophrenia. A substantially smaller literature suggests more negative than positive data with divalproex or carbamazepine in bipolar disorder, while minimal information exists regarding suicidality with atypical antipsychotics other than clozapine. Studies of antidepressants have mostly been short-term and have focused more on whether they induce (rather than ameliorate) suicidal thoughts or behaviors. The sum of existing studies is generally inconclusive about whether antidepressants appreciably reduce risk for suicide completions. Relatively little is known about pharmacotherapy effects on suicidal ideation as distinct from behaviors. Possible mechanistic considerations for understanding antisuicide properties include a therapeutic impact on depression, impulsivity, or aggression, potentially mediated through serotonergic or other neuromodulatory systems. Recommendations are provided to guide future research as well as clinical practice.

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“…A recent review identified 12 studies with people with a diagnosis of schizophrenia and adequate control groups assessing overall mortality in relation to antipsychotic exposure (Weinmann, Read, & Aderhold, 2009). Three of the five prospective studies evaluating the association between dosage and mortality showed a significant association between antipsychotic dosage (Loas, Azi, Noisette, & Yon, 2008) or antipsychotic polypharmacy (Joukamaa et al, 2006;Waddington et al, 1998) and overall mortality, whereas two studies (Montout et al, 2002;Morgan et al, 2003) did not show any influence of dosage. Of the four studies evaluating the association between antipsychotic polypharmacy and mortality, two found positive effects whereas two showed no greater risk with polypharmacy.…”

Section: Antipsychotic Side-effects and Mortalitymentioning

confidence: 99%

Antipsychotic medication, mortality and neurodegeneration: The need for more selective use and lower doses

Weinmann

Aderhold

2010

Psychosis

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Neuroleptics and mortality in schizophrenia: prospective analysis of deaths in a French cohort of schizophrenic patients

Cited by 66 publications

References 21 publications

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Antisuicide Properties of Psychotropic Drugs: A Critical Review

Antipsychotic medication, mortality and neurodegeneration: The need for more selective use and lower doses

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