| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Psychiatric Bulletin | Advances in Psychiatric Treatment | All RCPsych Journals |
|
|
|
||||||||||
|
||||||||||||
The British Journal of Psychiatry 173: 325-329 (1998)
© 1998 The Royal College of Psychiatrists
JL Waddington, HA Youssef and A Kinsella
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin. jwadding@rcsi.ie
BACKGROUND: Although increased mortality is one of the most consistent and accepted epidemiological findings in schizophrenia, a high rate of suicide appears unable to account fully for this burden which remains poorly understood. METHOD: A cohort of 88 in-patients was followed prospectively over a 10-year period and predictors of survival sought among demographic, clinical and treatment variables. RESULTS: Over the decade, 39 of the 88 patients (44%) died, with no instances of suicide. Reduced survival was predicted by increasing age, male gender, edentulousness and time since pre-terminal withdrawal of antipsychotics; additionally, two indices of polypharmacy predicted reduced survival: maximum number of antipsychotics given concurrently (relative risk 2.46, 95% CI 1.10-5.47; P = 0.03) and absence of co- treatment with an anticholinergic (relative risk 3.33, 95% CI 0.99- 11.11; P = 0.05). CONCLUSIONS: Receiving more than one antipsychotic concurrently was associated with reduced survival, in the face of little or no systematic evidence to justify the widespread use of antipsychotic polypharmacy. Conversely, over-cautious attitudes to the use of adjunctive anticholinergics may require re-evaluation.
This article has been cited by other articles:
|
|
 |
|
  B. Kirkpatrick, E. Messias, P. D. Harvey, E. Fernandez-Egea, and C. R. Bowie Is Schizophrenia a Syndrome of Accelerated Aging? Schizophr Bull, November 1, 2008; 34(6): 1024 - 1032. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Solomons, A. Treloar, and R. Noronha Competence of psychiatric clinicians in interpreting electrocardiograms and QT intervals: can they do this? Does it matter? Psychiatr. Bull., August 1, 2008; 32(8): 291 - 294. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. U. Correll, C. Rummel-Kluge, C. Corves, J. M. Kane, and S. Leucht Antipsychotic Combinations vs Monotherapy in Schizophrenia: A Meta-analysis of Randomized Controlled Trials Schizophr Bull, April 21, 2008; (2008) sbn018v2. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. HAZRA, D. C. MAMO, and G. REMINGTON Adjunctive Versus Monotherapeutic Treatment for Schizophrenia: Addressing Antipsychotic Side Effects Am J Psychiatry, March 1, 2008; 165(3): 396 - 397. [Full Text] [PDF]
|
|
|
|
|
|
G. B. K. Hung and H. K. Cheung A survey of in-patient and out-patient antipsychotic prescriptions in Hong Kong Psychiatr. Bull., March 1, 2008; 32(3): 103 - 105. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. F. Buckley, A. Foster, and B. Miller Schizophrenia Host Vulnerability and Risk of Metabolic Disturbances During Treatment with Antipsychotics Focus, January 1, 2008; 6(2): 172 - 179. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Saha, D. Chant, and J. McGrath A Systematic Review of Mortality in Schizophrenia: Is the Differential Mortality Gap Worsening Over Time? Arch Gen Psychiatry, October 1, 2007; 64(10): 1123 - 1131. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Chan and M. Sweeting Review: Combination therapy with non-clozapine atypical antipsychotic medication: a review of current evidence J Psychopharmacol, August 1, 2007; 21(6): 657 - 664. [Abstract] [PDF]
|
|
|
|
 |
|
 J. A. Kreyenbuhl, M. Valenstein, J. F. McCarthy, D. Ganoczy, and F. C. Blow Long-Term Antipsychotic Polypharmacy in the VA Health System: Patient Characteristics and Treatment Patterns Psychiatr Serv, April 1, 2007; 58(4): 489 - 495. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Ahmed, D. N Osser, C. M Boisvert, L. G Albert, and M. Aslam Rationale for Emphasis on Management over Treatment of Schizophrenia in Clinical Practice Ann. Pharmacother., April 1, 2007; 41(4): 693 - 695. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Abdelmawla and A. J. Mitchell Sudden cardiac death and antipsychotics. Part 2: Monitoring and prevention Advan. Psychiatr. Treat., March 1, 2006; 12(2): 100 - 109. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. G. Honer, A. E. Thornton, E. Y.H. Chen, R. C.K. Chan, J. O.Y. Wong, A. Bergmann, P. Falkai, E. Pomarol-Clotet, P. J. McKenna, E. Stip, et al. Clozapine Alone versus Clozapine and Risperidone with Refractory Schizophrenia N. Engl. J. Med., February 2, 2006; 354(5): 472 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. JOUKAMAA, M. HELIOVAARA, P. KNEKT, A. AROMAA, R. RAITASALO, and V. LEHTINEN Schizophrenia, neuroleptic medication and mortality The British Journal of Psychiatry, February 1, 2006; 188(2): 122 - 127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Abdelmawla and A. J. Mitchell Sudden cardiac death and antipsychotics. Part 1: Risk factors and mechanisms Advan. Psychiatr. Treat., January 1, 2006; 12(1): 35 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Ito, A. Koyama, and T. Higuchi Polypharmacy and excessive dosing: psychiatrists' perceptions of antipsychotic drug prescription The British Journal of Psychiatry, September 1, 2005; 187(3): 243 - 247. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Baldwin, D. Browne, P. J Scully, J. F Quinn, M. G Morgan, A. Kinsella, J. M Owens, V. Russell, E. O'Callaghan, and J. L Waddington Epidemiology of First-Episode Psychosis: Illustrating the Challenges Across Diagnostic Boundaries Through the Cavan-Monaghan Study at 8 Years Schizophr Bull, July 1, 2005; 31(3): 624 - 638. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Centorrino, J. L. Goren, J. Hennen, P. Salvatore, J. P. Kelleher, and R. J. Baldessarini Multiple Versus Single Antipsychotic Agents for Hospitalized Psychiatric Patients: Case-Control Study of Risks Versus Benefits Am J Psychiatry, April 1, 2004; 161(4): 700 - 706. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. O'Brien and F. Oyebode Psychotropic medication and the heart Advan. Psychiatr. Treat., November 1, 2003; 9(6): 414 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Inasu Risks of combination neuroleptic treatment The British Journal of Psychiatry, February 1, 2003; 182(2): 171 - 171. [Full Text] [PDF]
|
|
|
|
|
|
D. M. LAWRENCE, C. D'A. J. HOLMAN, A. V. JABLENSKY, and M. S. T. HOBBS Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980-1998 The British Journal of Psychiatry, January 2, 2003; 182(1): 31 - 36. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. Raedler, M. B. Knable, D. W. Jones, R. A. Urbina, J. G. Gorey, K. S. Lee, M. F. Egan, R. Coppola, and D. R. Weinberger In Vivo Determination of Muscarinic Acetylcholine Receptor Availability in Schizophrenia Am J Psychiatry, January 1, 2003; 160(1): 118 - 127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Taylor Antipsychotic prescribing -- time to review practice Psychiatr. Bull., November 1, 2002; 26(11): 401 - 402. [Full Text] [PDF]
|
|
|
|
|
|
C. A. Zarate Jr and J. Patel Sudden Cardiac Death and Antipsychotic Drugs: Do We Know Enough? Arch Gen Psychiatry, December 1, 2001; 58(12): 1168 - 1171. [Full Text] [PDF]
|
|
|
|
|
|
S. J. Kingsbury, D. Yi, and G. M. Simpson Psychopharmacology: Rational and Irrational Polypharmacy Psychiatr Serv, August 1, 2001; 52(8): 1033 - 1036. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Psychiatric Bulletin | Advances in Psychiatric Treatment | All RCPsych Journals |
