- 作者：Marjo Kiviniemi ; Jaana Suvisaari ; Heli Koivumaa-Honkanen ; Unto H?kkinen ; Matti Isohanni ; Helin? Hakko
- 关键词：Schizophrenia ; Antipsychotic ; Antidepressant ; Medication ; Mortality
- 刊名：Schizophrenia Research
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：150
- 期：1
- 页码：274-280
- 全文大小：254 K
Objective
Our aim was to assess the impact of the most commonly used typical and atypical antipsychotics on mortality of patients with first-onset schizophrenia.Method
We conducted a nationwide, register-based, five-year follow-up study of all patients presenting with first-onset of schizophrenia between 1998 and 2003. Details of reimbursed medicines were obtained from the register of Social Insurance Institution.
Results
After adjusting for age, gender, comorbid physical diseases and patient group, the use of second generation antipsychotics (SGAs), especially clozapine, olanzapine and quetiapine, was associated with reduced risk of all-cause mortality in patients with schizophrenia, while clozapine associated with lower suicide risk. First generation antipsychotics (FGAs), specifically levomepromazine, thioridazine or clorprothixene, were associated with increased risk of all-cause mortality. The FGAs, particularly clorprothixene, were associated with decreased suicide mortality. An increased likelihood for cardiovascular deaths was found among users of levomepromazine. In antidepressants, the use of mirtazapine associated with increased risk of suicide.
Conclusions
Differences exist between FGAs' and SGAs' use in relation to mortality. These differences remain even when the patient's physical illness are taken into account when prescribing antipsychotic medication.