Abstract
Background Schizophrenia patients have shorter life expectancy relative to that of the general population, and their suicide risk is reportedly higher. Although antipsychotic discontinuation rates are high, antipsychotic treatment has been associated with lower suicide mortality, and patients who do not use antipsychotics are at greater risk of suicide relative to those who use the medication. Furthermore, maintenance treatment with antipsychotic drugs protects schizophrenia patients from relapse. However, little is known about antipsychotic discontinuation, suicide risk, or the time during which suicide risk is highest following antipsychotic discontinuation. Therefore, this study investigated whether discontinuity of antipsychotics is associated with suicide in schizophrenia patients.Methods A population-based nested case-control study was conducted using the Korean National Health Insurance claims database (2002-2013). From the study population of 7,519 patients with the diagnosis of schizophrenia and at least one antipsychotics described, we identified 154 suicide cases and 760 matched controls. We calculated the days after last prescribed medication so that discontinuity of antipsychotics was defined. Conditional logistic regression were used to examine the association between discontinuity of antipsychotics and suicide adjusting for possible confounding covariates.Results Suicide risk was particularly high during the first thirty days after discharge after stopping antipsychotics compared with current user after adjusting all covariates (AOR: 4.667, 95% CI: 2.425–8.984).Conclusion Maintenance treatment with antipsychotics could help to reduce suicide risk. The results indicated that there is a need to monitor schizophrenia patients following antipsychotic discontinuation.
Sex-specific impact of socio-economic factors on suicide risk: a population-based case-control study in Denmark