Weighing the evidence for harm from long-term treatment with antipsychotic medications

A systematic review

Nancy Sohler, Ben G. Adams, David Barnes, Gregory H. Cohen, Seth J. Prins, Sharon Schwartz

Research output: Contribution to journalArticle

Abstract

Research findings supporting the use of antipsychotic medication for acute treatment of schizophrenia are relatively consistent and undisputed. However, the rationale for recommending long-term antipsychotic medication treatment-the current standard of care treatment strategy-is unclear. A controversial hypothesis proposed recently suggests people with schizophrenia who are exposed to long-term treatment with antipsychotic medications have worse outcomes than people with schizophrenia who are not exposed to these medications. We tested whether a systematic appraisal of published literature would produce data consistent with this hypothesis. We reviewed the published literature to identify studies of patients with psychotic disorders who were followed for at least 2 years that compared outcomes in patients who received antipsychotic medication during the follow-up with patients who did not receive antipsychotic medication during the follow-up. We included all English language articles published through 2013 in this review. Our process for selecting studies and documenting study findings included a consensus decision of 2 members of the research team. We found the published data to be inadequate to test this hypothesis. By extension, these data were also inadequate to conclusively evaluate whether long-term antipsychotic medication treatment results in better outcomes on average. We conclude that careful reappraisal of existing data is useful to ensure standard of care treatment strategies are indeed evidence-based. In the case of long-term use of antipsychotic medications, new data may be needed to establish a sufficient evidence base to understand its benefit/risk balance for patients with schizophrenia.

Original languageEnglish (US)
Pages (from-to)477-485
Number of pages9
JournalAmerican Journal of Orthopsychiatry
Volume86
Issue number5
DOIs
StatePublished - Jan 1 2016

Fingerprint

Antipsychotic Agents
Schizophrenia
Standard of Care
Therapeutics
Systematic Review
Harm
Medication
Research
Psychotic Disorders
Consensus
Language

Keywords

  • Antipsychotic medications
  • Mental health services
  • Psychosis

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Psychology (miscellaneous)
  • Psychiatry and Mental health

Cite this

Weighing the evidence for harm from long-term treatment with antipsychotic medications : A systematic review. / Sohler, Nancy; Adams, Ben G.; Barnes, David; Cohen, Gregory H.; Prins, Seth J.; Schwartz, Sharon.

In: American Journal of Orthopsychiatry, Vol. 86, No. 5, 01.01.2016, p. 477-485.

Research output: Contribution to journalArticle

Sohler, Nancy ; Adams, Ben G. ; Barnes, David ; Cohen, Gregory H. ; Prins, Seth J. ; Schwartz, Sharon. / Weighing the evidence for harm from long-term treatment with antipsychotic medications : A systematic review. In: American Journal of Orthopsychiatry. 2016 ; Vol. 86, No. 5. pp. 477-485.
@article{bb4f9f1d16874fd69684e4a1cc9da0ae,
title = "Weighing the evidence for harm from long-term treatment with antipsychotic medications: A systematic review",
abstract = "Research findings supporting the use of antipsychotic medication for acute treatment of schizophrenia are relatively consistent and undisputed. However, the rationale for recommending long-term antipsychotic medication treatment-the current standard of care treatment strategy-is unclear. A controversial hypothesis proposed recently suggests people with schizophrenia who are exposed to long-term treatment with antipsychotic medications have worse outcomes than people with schizophrenia who are not exposed to these medications. We tested whether a systematic appraisal of published literature would produce data consistent with this hypothesis. We reviewed the published literature to identify studies of patients with psychotic disorders who were followed for at least 2 years that compared outcomes in patients who received antipsychotic medication during the follow-up with patients who did not receive antipsychotic medication during the follow-up. We included all English language articles published through 2013 in this review. Our process for selecting studies and documenting study findings included a consensus decision of 2 members of the research team. We found the published data to be inadequate to test this hypothesis. By extension, these data were also inadequate to conclusively evaluate whether long-term antipsychotic medication treatment results in better outcomes on average. We conclude that careful reappraisal of existing data is useful to ensure standard of care treatment strategies are indeed evidence-based. In the case of long-term use of antipsychotic medications, new data may be needed to establish a sufficient evidence base to understand its benefit/risk balance for patients with schizophrenia.",
keywords = "Antipsychotic medications, Mental health services, Psychosis",
author = "Nancy Sohler and Adams, {Ben G.} and David Barnes and Cohen, {Gregory H.} and Prins, {Seth J.} and Sharon Schwartz",
year = "2016",
month = "1",
day = "1",
doi = "10.1037/ort0000106",
language = "English (US)",
volume = "86",
pages = "477--485",
journal = "American Journal of Orthopsychiatry",
issn = "0002-9432",
publisher = "American Orthopsychiatric Association Inc.",
number = "5",

}

TY - JOUR

T1 - Weighing the evidence for harm from long-term treatment with antipsychotic medications

T2 - A systematic review

AU - Sohler, Nancy

AU - Adams, Ben G.

AU - Barnes, David

AU - Cohen, Gregory H.

AU - Prins, Seth J.

AU - Schwartz, Sharon

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Research findings supporting the use of antipsychotic medication for acute treatment of schizophrenia are relatively consistent and undisputed. However, the rationale for recommending long-term antipsychotic medication treatment-the current standard of care treatment strategy-is unclear. A controversial hypothesis proposed recently suggests people with schizophrenia who are exposed to long-term treatment with antipsychotic medications have worse outcomes than people with schizophrenia who are not exposed to these medications. We tested whether a systematic appraisal of published literature would produce data consistent with this hypothesis. We reviewed the published literature to identify studies of patients with psychotic disorders who were followed for at least 2 years that compared outcomes in patients who received antipsychotic medication during the follow-up with patients who did not receive antipsychotic medication during the follow-up. We included all English language articles published through 2013 in this review. Our process for selecting studies and documenting study findings included a consensus decision of 2 members of the research team. We found the published data to be inadequate to test this hypothesis. By extension, these data were also inadequate to conclusively evaluate whether long-term antipsychotic medication treatment results in better outcomes on average. We conclude that careful reappraisal of existing data is useful to ensure standard of care treatment strategies are indeed evidence-based. In the case of long-term use of antipsychotic medications, new data may be needed to establish a sufficient evidence base to understand its benefit/risk balance for patients with schizophrenia.

AB - Research findings supporting the use of antipsychotic medication for acute treatment of schizophrenia are relatively consistent and undisputed. However, the rationale for recommending long-term antipsychotic medication treatment-the current standard of care treatment strategy-is unclear. A controversial hypothesis proposed recently suggests people with schizophrenia who are exposed to long-term treatment with antipsychotic medications have worse outcomes than people with schizophrenia who are not exposed to these medications. We tested whether a systematic appraisal of published literature would produce data consistent with this hypothesis. We reviewed the published literature to identify studies of patients with psychotic disorders who were followed for at least 2 years that compared outcomes in patients who received antipsychotic medication during the follow-up with patients who did not receive antipsychotic medication during the follow-up. We included all English language articles published through 2013 in this review. Our process for selecting studies and documenting study findings included a consensus decision of 2 members of the research team. We found the published data to be inadequate to test this hypothesis. By extension, these data were also inadequate to conclusively evaluate whether long-term antipsychotic medication treatment results in better outcomes on average. We conclude that careful reappraisal of existing data is useful to ensure standard of care treatment strategies are indeed evidence-based. In the case of long-term use of antipsychotic medications, new data may be needed to establish a sufficient evidence base to understand its benefit/risk balance for patients with schizophrenia.

KW - Antipsychotic medications

KW - Mental health services

KW - Psychosis

UR - http://www.scopus.com/inward/record.url?scp=84949921502&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949921502&partnerID=8YFLogxK

U2 - 10.1037/ort0000106

DO - 10.1037/ort0000106

M3 - Article

VL - 86

SP - 477

EP - 485

JO - American Journal of Orthopsychiatry

JF - American Journal of Orthopsychiatry

SN - 0002-9432

IS - 5

ER -