Neuroleptics and mortality in schizophrenia: prospective analysis of deaths in a French cohort of schizophrenic patients

Objective: The putative role of neuroleptics in the known excess mortality of subjects with schizophrenia remains disputed. The aim of this study was to assess the link between mortality and the class of neuroleptic. Method: Causes of death (suicide, cardiovascular, etc,) and exposure to neuroleptics were studied in a cohort of 3474 patients with schizophrenia followed from 1993 to 1997. Results: From 1993 to 1997, 178 patients died. The risk of all-cause death (OR= 1,59; 95% CI 1.02-2,50; p = 0.04), and suicide (OR = 2.22; 95% Cl 1.24-3.97; p = 0.006) were increased in users of thioxanthenes (alone or associated with other drugs), and increased risk of "other causes" of death was associated with use of atypical neuroleptics (OR= 2.06; 95% Cl 1.15-3.70; p = 0.0016). Conclusion: Our findings suggest the existence of association between certain classes of neuroleptics and death, all cause or specific. This could be related to the drug itself or to patient selection. (C) 2002 Elsevier Science B.V. All rights reserved.