Antipsychotics do help many with schizophrenia, study finds

The study, involving data stretching back 50 years, also found that schizophrenia patients who take antipsychotics are much less likely to be hospitalized and may behave less aggressively and have a better quality of life than patients who don't take the drugs.

One expert said the finding mirrors what he and other professionals have experienced.

The data "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.

The findings are published in the May 3 online edition of The Lancet.

In the study, German researchers combed through findings from 65 clinical trials reported in 116 articles published between 1959 and 2011. The trials included nearly 6,500 patients with schizophrenia.

After one year, relapse rates were 27 percent among patients who took antipsychotic drugs and 64 percent among those who took an inactive placebo, the review found. Rates of hospital readmission were 10 percent for patients who took antipsychotics and 26 percent for those who took a placebo.

Evidence from five studies indicated 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 people with schizophrenia, but they can cause serious side effects. Indeed, the investigators found that patients who took antipsychotic drugs had more negative side effects than those who took a placebo, including movement disorders (16 percent versus 9 percent), sedation (13 percent versus 9 percent), and weight gain (10 percent versus 6 percent).

Antipsychotic medications can also be expensive, the authors noted. In 2010, about $18.5 billion was spent worldwide on antipsychotic drugs, according to a journal news release.

Estrada agreed that the drugs have their drawbacks. "The cost and adverse effects associated with antipsychotics remain major impediments to achieving more successful treatment of schizophrenia," he said. "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 take-home message from the new study is clear, the study authors said.

"Antipsychotic maintenance treatment substantially reduces relapse risk in all patients with schizophrenia for up to 2 years of follow-up," Stefan Leucht from the Technical University of Munich, and colleagues, said 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 seemed to occur 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.

Another expert said that, while the medications are not perfect, they have eased the suffering of many patients.

"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.

More information: The U.S. National Institute of Mental Health has more about schizophrenia.

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