Is the Schizophrenia Mortality Study in The Lancet CREDIBLE?
Friday, 17 July 2009
Unless the overall treatment and services provided to schizophrenia patients in Finland is unique and especially protective—which the authors do not suggest—their claimed findings of lowered mortality rates for antipsychotic drug users are belied by a consistent body of evidence.
A study purporting to analyze mortality rates of 66, 881 schizophrenia patients in Finland (1973 to 2005) was published in the prestigious journal, The Lancet. [Abstract below]
The study has received much media attention because the authors claim—contrary to well documented previous reports about spiraling mortality rates among schizophrenia patients treated between the 1970s and 2000 [1, 2, 3, 4, 5, 6]—that the use of the second generation antipsychotic drugs in Finland was associated with lower mortality rate compared to no drug treatment.
What’s more, the authors claim that Clozaril (clozapine) among all antipsychotics was associated with the lowest number of deaths, and its restricted use should therefore be reassessed for use a first-line treatment. Unless the overall treatment and services provided to schizophrenia patients in Finland is unique and especially protective—which the authors do not suggest—their claimed findings are belied by a consistent body of evidence.
To whit, an eight year study of FDA MedWatch adverse drug reports (between 1998 to 2005) found that Clozapine was linked to 3,277 deaths, making it the third most dangerous prescribed drug in the U.S. Clozapine was also linked to over 4,300 adverse drug events that led to disability or required serious medical intervention. 
A critical analysis by psychiatrist, Grace Jackson, MD (below), identifies fatal flaws in the study design and numerous methodological artifacts that introduced bias which minimized the detection of drug-related mortality.