Use of Benzodiazepines and Antipsychotic Drugs Are Inversely Associated With Acute Readmission Risk in Schizophrenia

Abstract

Purpose Little is known about the impact of different psychotropic drugs on acute readmission risk, when used concomitantly in a real-life setting. We aimed to investigate the association between acute readmission risk and use of antipsychotic drugs, antidepressants, mood stabilizers, and benzodiazepines in patients with schizophrenia. Methods A cohort study included all patients diagnosed with schizophrenia admitted to a psychiatric acute unit at Haukeland University Hospital in Bergen, Norway, during a 10-year period (N = 663). Patients were followed from discharge until first readmission or censoring. Cox multiple regression analyses were conducted using antipsychotic drugs, antidepressants, mood stabilizers, and benzodiazepines as time-dependent variables, and periods of use and nonuse were compared within individual patients. Adjustments were made for sex, age at index admission, and excessive use of alcohol and illicit substances. Results A total of 410 patients (61.8%) were readmitted during follow-up, and the mean and median times in days to readmission were 709 and 575, respectively. Compared with nonuse, the use of antipsychotic drugs was associated with reduced risk of readmission (adjusted hazards ratio, 0.20; P < 0.01; confidence interval, 0.16–0.24), and the use of benzodiazepines was associated with increased risk of readmission (adjusted hazards ratio, 1.51; P < 0.01; confidence interval, 1.13–2.02). However, no relation to readmission risk was found for the use of antidepressants and mood stabilizers. Conclusions We found that use of benzodiazepines and antipsychotic drugs are inversely associated with acute readmission risk in schizophrenia.

Prescribing and deprescribing trends in schizophrenia: An overview of inpatients in Belgium and in the Canadian province of Québec

“…BZRAs, low‐dose trazodone) in the Belgian sites than in the Canadian hospital, both on admission and at discharge. BZRAs are often prescribed in a context of psychotic agitation or to induce sedation, but their use should be temporary, 14 especially as BZRAs' augmentation in schizophrenia increases the risks of both suicidal and non‐suicidal death, emergency visit and rehospitalizations 46–49 . Moreover, a larger number of low‐dose antipsychotics were prescribed in Belgium compared with Canada for treatment of sleep disorders.…”

“…BZRAs are often prescribed in a context of psychotic agitation or to induce sedation, but their use should be temporary, 14 especially as BZRAs' augmentation in schizophrenia increases the risks of both suicidal and non-suicidal death, emergency visit and rehospitalizations. [46][47][48][49] Moreover, a larger number of low-dose antipsychotics were prescribed in Belgium compared with Canada for treatment of sleep disorders. Offlabel use of antipsychotics is increasing worldwide, 50,51 even though the efficacy of adding a low-dose antipsychotic to an antipsychotic at a regular dose to improve sleep has never been studied in patients with schizophrenia.…”

Cotard’s syndrome in a patient with schizophrenia-spectrum disorder

“…The patient’s dose of quetiapine was subsequently increased to 300 mg nightly, and she was initiated on oxcarbazepine 300 mg oral, two times per day to provide further mood stabilisation. The benefit of including both a second-generation antipsychotic and an antiepileptic/mood stabiliser such as oxcarbazepine is that in combination these drugs can better reduce this patient’s anxiety and ‘may provide better general outcomes than antipsychotics administrated alone’ 7…”

Integrative Roles of Dopamine Pathway and Calcium Channels Reveal a Link between Schizophrenia and Opioid Use Disorder

“…Patients with first episode psychosis were more likely to be cannabis users [ 7 ], and therefore adolescent cannabis might increase the risk of schizophrenia [ 8 , 9 , 10 ]. Moreover, illicit drugs worsen schizophrenia symptoms, limit treatment compliance, increase psychotic relapse and hospitalization, and increase the risks of readmission and suicide [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. There are some explanations for the link between schizophrenia and addiction, and one of them suggests that these two disorders are influenced by a common biological trait.…”