Polypharmacy with antipsychotics, antidepressants, or benzodiazepines and mortality in schizophrenia.

摘要: Context Polypharmacy is widely used in the treatment of schizophrenia, although it believed to have major adverse effects on well-being patients. Objective To investigate if use benzodiazepines, antidepressants, or multiple concomitant antipsychotics associated with increased mortality among patients schizophrenia. Design Registry-based case linkage study. Setting Academic research. Patients We linked national databases and medication prescriptions a complete nationwide cohort 2588 hospitalized Finland for first time diagnosis schizophrenia between January 1, 2000, December 31, 2007. Main Outcome Measures Hazard ratios (HRs) were computed all-cause during antipsychotics, benzodiazepines outpatient care, adjusting sociodemographic clinical variables, geographic location, current past pharmacological treatments. Results Compared antipsychotic monotherapy, 2 more was not (HR, 0.86; 95% CI, 0.51-1.44). Similarly, antidepressant higher risk 0.57; 0.28-1.16) markedly decreased suicide deaths 0.15; 0.03-0.77). However, benzodiazepine substantial increase 1.91; 1.13-3.22), this attributable suicidal 3.83; 1.45-10.12) nonsuicidal 1.60; 0.86-2.97). In total, 826 904 (91.4%) who had purchased that contained than 28 defined daily doses, violating guidelines. Conclusions Benzodiazepine marked whereas an several not. Antidepressant deaths. The literature indicates long-term prevalent other countries (eg, United States) compared Finland, which suggests may contribute patient population worldwide.