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Suicide risk and antipsychotic side effects in schizophrenia: nested case-control study
Johan Reutfors1, Eric Clapham2, Shahram Bahmanyar1,3
1Centre for Pharmacoepidemiology (CPE), Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Human Psychopharmacology
|April 26, 2016
Summary
Patients with schizophrenia experiencing extrapyramidal symptoms (EPS) showed a reduced suicide risk. This may indicate better medication adherence or higher dosages in those with EPS.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Schizophrenia is associated with a high risk of suicide.
- Antipsychotic medications are the cornerstone of schizophrenia treatment, but their side effects are a concern.
Purpose of the Study:
- To investigate the association between antipsychotic side effects and suicide risk in schizophrenia patients.
- To explore if extrapyramidal symptoms (EPS), akathisia, or anticholinergic medication use modify suicide risk.
Main Methods:
- A case-control study was conducted using data from Stockholm County (1984-2000).
- 84 schizophrenia or schizoaffective disorder patients who died by suicide were matched with controls.
- Antipsychotic side effects (EPS, akathisia) and anticholinergic use were assessed from clinical records.
Main Results:
- A history of EPS was associated with a significantly lower suicide risk (aOR 0.33, 95% CI 0.12-0.94).
- No significant association was found between akathisia or anticholinergic medication use and suicide risk.
Conclusions:
- The reduced suicide risk in patients with EPS might suggest better antipsychotic treatment adherence, higher dosage, or polypharmacy.
- Further research is needed to understand the complex relationship between antipsychotic side effects and suicide in schizophrenia.
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