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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by shadowtom2 on August 5, 2016, at 17:11:55
I thought that I'd post a link to an article from the Psychiatric Times that I came across that discussed the findings of a very large study that looked at the mortality risk associated with the use of various psychiatric medications, since this is a topic that seems to come up on these boards frequently. I'll say really quickly that the study mentioned in the article found all levels of exposure to antipsychotics or antidepressants to be associated with a significantly lower overall mortality compared with no use of antipsychotics or antidepressants. However, exposure to benzodiazepines was associated with a significant higher risk of overall mortality compared with no benzodiazepine use.
Here's a link to the full article:
http://www.psychiatrictimes.com/schizophrenia/which-psychotropics-risk-deathTom
Posted by Phillipa on August 5, 2016, at 17:48:49
In reply to Study on medications and risk of death, posted by shadowtom2 on August 5, 2016, at 17:11:55
Reads high doses of benzos and not low doses. Phillipa
Posted by shadowtom2 on August 5, 2016, at 19:05:28
In reply to Re: Study on medications and risk of death » shadowtom2, posted by Phillipa on August 5, 2016, at 17:48:49
Phillipa,
Here's the exact quote from the Psychiatric Times article:
"By contrast, exposure to benzodiazepines was associated with a significantly higher overall mortality, with a 74% higher risk of death in subjects with high exposure compared with no use."
My thinking as I was reading that sentence was that the author of the article seemed to be saying that the risk of overall mortality was significantly higher among those who've taken benzodiazepines than it was among those who haven't taken benzodiazepines, with the risk being the highest (74 percent higher than those in the "no exposure" group) among those whose cumulative exposure to to the medications was at a high level. I took a look at the actual paper that was published in the American Journal of Psychiatry (which can be found here:https://www.researchgate.net/profile/Kristina_Alexanderson/publication/286510395_Mortality_and_Cumulative_Exposure_to_Antipsychotics_Antidepressants_and_Benzodiazepines_in_Patients_With_Schizophrenia_An_Observational_Follow-Up_Study/links/569e344008ae950bd7a94709.pdf), and even though I still think that it's technically correct that the mortality risk among those from the study who took benzodiazepines was higher overall than it was for those who didn't take the medications, those from the group who had a low cumulative exposure to benzodiazepines actually did not at all seem to have a higher mortality risk than those who didn't taken any benzodiazepines. So, what you said about the mortality risk not being higher among those whose exposure to benzodiazepines was low in comparison to those who didn't take benzodiazepines is correct.
However, as far as the mortality rates for those in both the "moderate exposure" group and the "high exposure" group for benzodiazepines were concerned, they were significantly higher than the mortality rate was for those who didn't take benzodiazepines. According to the authors of the paper, "In a sensitivity analysis among first-episode patients (1,230 patients, 45 deaths), the only statistically significant findings were a decreased risk of death for low (adjusted hazard ratio=0.47, 95% CI=0.230.97) and moderate (adjusted hazard ratio=0.18, 95% CI=0.070.45) exposure to antipsychotics, and increased mortality for moderate (adjusted hazard ratio=2.72, 95% CI=1.106.73) and high (adjusted hazard ratio=3.86, 95% CI=1.41 10.55) exposure to benzodiazepines."
I'd also like to make it clear that the study that was discussed in the Psychiatric Times article and that I've also discussed here looked specifically at patients who had been diagnosed with schizophrenia and not at a more diverse group of patients with mental health conditions. I didn't make this clear in the first post that I made to this thread.
Tom
Posted by Phillipa on August 5, 2016, at 22:19:11
In reply to Re: Study on medications and risk of death » Phillipa, posted by shadowtom2 on August 5, 2016, at 19:05:28
I did see that about schizophrenia so it applies to this population. I know my doc knows that it isn't an issue for me to continue on them been on them 2/3 of my life. Same or lower doses. Phillipa
Posted by Lou Pilder on August 6, 2016, at 8:00:16
In reply to Re: Study on medications and risk of death » Phillipa, posted by shadowtom2 on August 5, 2016, at 19:05:28
> Phillipa,
>
> Here's the exact quote from the Psychiatric Times article:
>
> "By contrast, exposure to benzodiazepines was associated with a significantly higher overall mortality, with a 74% higher risk of death in subjects with high exposure compared with no use."
>
> My thinking as I was reading that sentence was that the author of the article seemed to be saying that the risk of overall mortality was significantly higher among those who've taken benzodiazepines than it was among those who haven't taken benzodiazepines, with the risk being the highest (74 percent higher than those in the "no exposure" group) among those whose cumulative exposure to to the medications was at a high level. I took a look at the actual paper that was published in the American Journal of Psychiatry (which can be found here:https://www.researchgate.net/profile/Kristina_Alexanderson/publication/286510395_Mortality_and_Cumulative_Exposure_to_Antipsychotics_Antidepressants_and_Benzodiazepines_in_Patients_With_Schizophrenia_An_Observational_Follow-Up_Study/links/569e344008ae950bd7a94709.pdf), and even though I still think that it's technically correct that the mortality risk among those from the study who took benzodiazepines was higher overall than it was for those who didn't take the medications, those from the group who had a low cumulative exposure to benzodiazepines actually did not at all seem to have a higher mortality risk than those who didn't taken any benzodiazepines. So, what you said about the mortality risk not being higher among those whose exposure to benzodiazepines was low in comparison to those who didn't take benzodiazepines is correct.
>
> However, as far as the mortality rates for those in both the "moderate exposure" group and the "high exposure" group for benzodiazepines were concerned, they were significantly higher than the mortality rate was for those who didn't take benzodiazepines. According to the authors of the paper, "In a sensitivity analysis among first-episode patients (1,230 patients, 45 deaths), the only statistically significant findings were a decreased risk of death for low (adjusted hazard ratio=0.47, 95% CI=0.230.97) and moderate (adjusted hazard ratio=0.18, 95% CI=0.070.45) exposure to antipsychotics, and increased mortality for moderate (adjusted hazard ratio=2.72, 95% CI=1.106.73) and high (adjusted hazard ratio=3.86, 95% CI=1.41 10.55) exposure to benzodiazepines."
>
> I'd also like to make it clear that the study that was discussed in the Psychiatric Times article and that I've also discussed here looked specifically at patients who had been diagnosed with schizophrenia and not at a more diverse group of patients with mental health conditions. I didn't make this clear in the first post that I made to this thread.
>
> TomFriends,
Be not deceived. There are those that want to mislead you to think that these drugs are safer than they really are. This could lead to your death.
Let us first look at this:
Lou
http://resources.childhealthecare.org/resources/Psychotropic_Meds_Arrhythmia_and_Sudden_Death.pdf
Posted by shadowtom2 on August 6, 2016, at 9:45:03
In reply to Study on medications and risk of death, posted by shadowtom2 on August 5, 2016, at 17:11:55
I already mentioned some of what I'm about to say in my reply to Phillipa, but I wanted to make a separate post to point out that the participants who were looked at for the study that I've been discussing here (and that the Psychiatric Times article also discussed) had all been diagnosed with schizophrenia. Additionally, the participants were between the ages of 17 and 65 and were living in Sweden in 2005. In total, the researchers identified 21,492 participants for the study. Perhaps this isn't something that everybody here knows, but the onset of schizophrenia is understood to occur most commonly during late adolescence or early adulthood.
Tom (the former Tomatheus)
Posted by linkadge on August 6, 2016, at 14:14:38
In reply to Lou's response- » shadowtom2, posted by Lou Pilder on August 6, 2016, at 8:00:16
Lou,
You're wrong. It's that simple.
Linkadge
Posted by rjlockhart37 on August 6, 2016, at 21:33:20
In reply to Study on medications and risk of death, posted by shadowtom2 on August 5, 2016, at 17:11:55
i think i could see why antipsychosics would produce an earlier death, because they block the nuerotransmittters, while as benzo's just activate a nuerotransmitter GABA.....
i've thought about that....because zyprexa has relieved my thoughts, but it's blocking nuerotransmitters, like blocking a water valve....it could have indirect pressure that would cause more problems
Posted by shadowtom2 on August 6, 2016, at 23:50:50
In reply to Re: Study on medications and risk of death, posted by rjlockhart37 on August 6, 2016, at 21:33:20
I think it makes sense that antipsychotic medications can cause certain problems, and there is, of course, evidence that the use of these medications does sometimes seem to lead to some undesirable health outcomes. However, as far as the risk of death in patients with schizophrenia is concerned (particularly in those between the ages of 17 and 65, which is the age range of the participants who were looked at for the study that I've been writing about here), "low exposure" and "moderate exposure" to antipsychotic medications was actually associated with a significantly reduced risk of death -- and not an increased risk of death -- based on the findings of this study.
I'm not sure about the extent to which the findings of this study might be able to be generalized to other patient populations. I know that antipsychotic medications tend to increase the risk of death in elderly patients with dementia, so the findings of the study that I've been writing about here clearly wouldn't seem to apply to this group of individuals. The findings of the study also might not apply to other patient groups, such as those with mood disorders, but at the same time, it's also possible that a study that would look at the relationship between medication use and risk of death in patients with mood disorders might produce similar findings. Finally, I think it's possible that antipsychotic medications could produce effects in certain individuals with schizophrenia that might increase their risk of death, but statistically speaking, based on the findings of the study that I've been writing about, "low exposure" and "moderate exposure" to antipsychotics tends to be associated with a significantly reduced risk of death in patients with schizophrenia, when looked at in comparison to no exposure to these kinds of medications.
Tom
This is the end of the thread.
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