A new publication reports on antipsychotic medications in people with schizophrenia. Of course schizophrenia is very different from tic disorders. Nevertheless, the medications best proven to reduce tic severity are also used as antipsychotics. In both populations concerns arise about the long-term impacts of physical side effects of antipsychotics, especially with regards to obesity and cardiovascular events.
This study examined records from everyone in Finland over a 20-year period, so it has the power to detect even small differences. The bottom line was that non-psychiatric hospitalizations generally, and cardiovascular hospitalizations specifically, were identical in patients when on vs. off antipsychotics. In people with schizophrenia, the medications were overall dramatically life-saving, with over a 50% reduction in mortality (including a 38% reduction specifically in cardiovascular deaths).
Antipsychotic medications still carry meaningful risks along with their proven benefits for tic reduction, and the risks and benefits need to be balanced for each individual. Other effective treatments are available. Nevertheless, this new data provides reassurance regarding the overall long-term safety of antipsychotic medication use for those who need it.
Taipale H, et al: 20-year follow-up study of physical morbidity and mortality in
relationship to antipsychotic treatment in a nationwide cohort of
62,250 patients with schizophrenia (FIN20). World Psychiatry 2020; 19(1):61–68. DOI: 10.1002/wps.20699