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Updated: Feb 14, 2026

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Published on: December 2, 2015
Comparative effect of antipsychotics on risk of self-harm among patients with schizophrenia
C-H Ma1, S-S Chang2, H-J Tsai3,4,5
1Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Objective:
To investigate the association of different antipsychotic treatments with hospitalization due to self-harm among patients with schizophrenia.
Method:
This retrospective cohort study was based on Taiwan's universal health insurance database. Patients aged 15-45 years with a newly diagnosed schizophrenic disorder in 2001-2012 were included. The study outcome was the first hospitalization due to self-harm or undetermined injury after the diagnosis of schizophrenic disorders. The exposure status of antipsychotics was modeled as a time-dependent variable. The analyses were stratified by antipsychotic dosage based on defined daily dose (DDD).
Results:
Among 70 380 patients with a follow-up of 500 355 person-years, 2272 self-harm hospitalization episodes were identified. Compared with none or former use, current use of several second-generation antipsychotics with a dose of one DDD or above, including amisulpride, aripiprazole, clozapine, risperidone, and sulpiride, was associated with decreased risk of self-harm hospitalization, with clozapine showing the strongest effect (adjusted rate ratio = 0.26, 95% confidence interval 0.15-0.47).
Conclusion:
The protective effect on self-harm may vary across different antipsychotics. Further studies are needed to replicate the findings.
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