A new study confirms that when people with schizophrenia take antipsychotic drugs, they are much less likely to be hospitalized, may behave less aggressively and have a better quality of life than patients who don’t take the medication. The drugs also cut the patients’ risk of relapse by 60 percent.
The data from the study stretches back 50 years and “is consistent with what we see in clinical practice — that we are very well able to keep our patients functioning better and out of the hospital when they consistently take these medications,” said Dr. Roberto Estrada, attending psychiatrist at Lenox Hill Hospital in New York City.
For the study, German researchers searched through findings from 65 clinical trials reported in 116 articles published between 1959 and 2011. The trials involved nearly 6,500 patients with schizophrenia.
Researchers found that, after one year, relapse rates were 27 percent among patients who took antipsychotic drugs and 64 percent among those who took an inactive placebo. For patients taking antipsychotics, rates of hospital readmission were 10 percent compared to 26 percent for those taking placebo.
Five studies showed evidence that patients who took antipsychotic drugs behaved less aggressively, and findings from three studies suggested that they have a better quality of life.
Antipsychotic drugs are the main type of treatment for schizophrenia, but they can cause serious side effects. Researchers found that patients who took antipsychotic drugs had more negative side effects than those who took a placebo, including movement disorders (16 percent vs 9 percent), sedation (13 percent vs 9 percent), and weight gain (10 percent vs 6 percent).
Antipsychotic drugs can also be expensive, said the authors. In 2010, about $18.5 billion was spent worldwide on antipsychotic drugs, according to a journal news release.
“The cost and adverse effects associated with antipsychotics remain major impediments to achieving more successful treatment of schizophrenia,” said Estrada. “Further work needs to be done to develop more effective treatments for schizophrenia that are better-tolerated and thus likely to improve patients’ adherence to taking these medications.”
Still, the overall message from the new study is clear, noted the study authors.
“Antipsychotic maintenance treatment substantially reduces relapse risk in all patients with schizophrenia for up to two years of follow-up,” said psychiatrist Dr. Stefan Leucht, from the Technical University of Munich, and colleagues in a journal news release.
“The effect was robust in important subgroups such as patients who had only one episode, those in remission,” he added.
Benefits were witnessed regardless of whether patients took older or newer forms of antipsychotic drugs, Leucht added. However, for many patients “the drugs seemed to lose their effectiveness with time,” he said.
Although the medications have drawbacks, they have eased the suffering of those with schizophrenia.
“This study confirms clinical observations going back to the early 1950s — that is, antipsychotic drugs are effective in reducing the symptoms associated with schizophrenia. The decreased number of patients in long-term mental health facilities, such as state mental hospitals, is a testimonial to this,” said Dr. Norman Sussman, a psychiatrist at NYU Langone Medical Center and professor at the NYU School of Medicine in New York City.
“Hopefully, even better treatments will emerge in the near future that have fewer adverse effects and more robust therapeutic impact on cognition and social functioning,” Sussman said.
The findings are published in the online edition of The Lancet.
Source: The Lancet