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Progress in Neuro-psychopharmacology & Biological Psychiatry

No clear antipsychotic–death link in schizophrenia with dementia

The adjusted hazard ratio—a relative measure of death risk—was 0.976 for early prescriptions versus none recorded, with no statistically significant difference.

Paper by Sra Jung, Minseok Hong, Dong Hyeon Lee, +3 more authorsWonsuk Shin
Figure 1 from Progress in Neuro-psychopharmacology & Biological Psychiatry
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Figure 1. Jung et al.

Our read

Populations
Studied:
Cohort study of 28,506 people
In the record:
One of 7 papers on second-generation antipsychotics on record: 2 with results in people.
Why it’s aging research:
It measures an outcome that worsens with age.

Editor of record: Boris Djordjevic · AgingResearch.News

Paper
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In South Korea, 28,506 patients with schizophrenia and a dementia diagnosis recorded in insurance claims were studied in a retrospective observational cohort. All survived the first 90 days after diagnosis. Researchers used national insurance records from 2002–2022 and matched 14,253 pairs by recorded characteristics. They compared patients prescribed antipsychotic drugs during those 90 days with patients without a recorded prescription.

Mortality did not differ significantly between these groups. Separate matched comparisons found no significant mortality difference between first- and second-generation drugs. Among second-generation drug users, higher study-defined risks of metabolic problems or prolonged electrical recovery between heartbeats were linked to higher mortality. The adjusted hazard ratios were 1.238 and 1.109, respectively.

Why it matters

Dementia care raises questions about how psychiatric drug choices relate to survival in people who also have schizophrenia.

Caveats

Patients with and without prescriptions may have differed in health factors not captured by insurance claims. The findings apply to people who survived the initial 90 days, and prescription records did not establish sustained use or non-use afterward.

Where the evidence stands

Antipsychotics

Humans: replicated by independent labs. Cells: a single group. Worms or flies and mice: nothing yet.

C, W, M, H: cells, worms or flies, mice, humans. Dark: independent labs found the same change there. Light: one lab or one study. Outline: nothing yet.

Labs are independent when their papers share no last author and no institution.

Against: findings that point the other way from most findings on the same outcome.

No results posted: trials that ended over a year ago with no results on ClinicalTrials.gov and no paper reporting them.

Company ties: findings with an author at a company, or from a paper whose competing-interests statement declares ties to one.

  • 50 independent labs in 23 countries
  • 11 findings against
  • 6 trials, 3 with no results posted
  • Funders: National Institute on Aging and others
  • 10 of 66 findings with company ties

Second-generation antipsychotics

Humans: a single group. Cells, worms or flies and mice: nothing yet.

C, W, M, H: cells, worms or flies, mice, humans. Dark: independent labs found the same change there. Light: one lab or one study. Outline: nothing yet.

Labs are independent when their papers share no last author and no institution.

Against: findings that point the other way from most findings on the same outcome.

  • 2 independent labs in 1 country
  • 1 finding against
  • 1 trial

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