The majority of schizophrenia patients in Finland stop taking their antipsychotics within 60 days of discharge


We know that many people who take antipsychotic drugs find it difficult to cope with the side effects of the medication and this often leads to them stopping their treatment.

This large Finish cohort study examines the risks of rehospitalisation and drug discontinuation in patients recently diagnosed with schizophrenia who have been prescribed antipsychotics.

The study drew on data from national databases of hospitalisation, mortality, antipsychotic prescriptions and computed hazard ratios. The researchers adjusted for the effects of sociodemographic and clinical variables, the temporal sequence of the antipsychotics used, and the choice of the initial antipsychotic for each patient. 2,588 people were included in the study.

Here’s what they found:

  • Only 58.2% collected a prescription for an antipsychotic during the first 30 days after hospital discharge
  • 45.7% continued their initial treatment for 30 days or longer (95% confidence interval [CI]=43.7-47.6)
  • The risk of rehospitalisation for patients receiving depot medications was about one-third of that for patients receiving oral medications (adjusted hazard ratio=0.36, 95% CI=0.17-0.75)
  • Compared with oral risperidone, clozapine (adjusted hazard ratio=0.48, 95% CI=0.31-0.76) and olanzapine (adjusted hazard ratio=0.54, 95% CI=0.40-0.73) were each associated with a significantly lower rehospitalisation risk
  • Use of any antipsychotic compared with no antipsychotic was associated with lower mortality (adjusted hazard ratio=0.45, 95% CI=0.31-0.67).

The authors concluded:

In Finland, only a minority of patients adhere to their initial antipsychotic during the first 60 days after discharge from their first hospitalization for schizophrenia. Use of depot antipsychotics was associated with a significantly lower risk of rehospitalization than use of oral formulations of the same compounds. Among oral antipsychotics, clozapine and olanzapine were associated with more favorable outcomes. Use of any antipsychotic was associated with lower mortality.

Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry. 2011 Jun;168(6):603-9. Epub 2011 Mar 1. [PubMed abstract]

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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