Antipsychotics and mortality – more clarity needed

Nobody can fail to be intrigued by, if not sceptical of, studies which appear to show that the prescribing of antipsychotics [which can cause weight gain, metabolic disturbance, QT prolongation, akathisia-linked suicide (Salem, Nagpal, Pigott, & Teixeira, 2017) and dose-related sudden cardiac death (Ray, Chung, Murray, Hall, & Stein, 2009)] results in people living longer than those not prescribed these drugs. The expectation, of course, is that people taking antipsychotics live relatively short lives, and that those prescribed antipsychotics with the greatest toxic effects (such as clozapine) have amongst the highest mortality (Taylor, Douglas-Hall, Olofinjana, Whiskey, & Thomas, 2009), not the lowest. The onus of ‘proof’ therefore is on the researchers claiming that antipsychotic use prolongs life. Their responsibility is not so much to posit an explanation for their surprising findings, but show without doubt that their research methods and findings accurately reflect reality.