Schizophrenia and the increased mortality associated with benzodiazepines - Sovereign Health Group
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“Somewhere between the ages of 19 and 21, I was exposed to the mathematical idea of fractals. I began to think obsessively about fractals and infinity. I thought I was going to discover some incredible and fabulous mathematical principle that would transform the way we view the universe. This delusion occupied my thoughts all day long, every day. I couldn’t concentrate on my regular university studies, and my academic career eventually ended in failure. Still, I thought I was going to become famous. I was a genius just waiting to be discovered by the world. Soon everyone would know who I was because I was going to solve the riddle of the universe. I was having grandiose ideation.” Kurt Snyderwas diagnosed with schizophrenia after developing symptoms over a nine-year period and he recounts his journey throughout the years of paranoia, delusions and hallucinations.

Side effects from treatment

Schizophrenia is generally treated with antipsychotic medications, which change the composition of serotonin, histamine and/or dopamine in the brain, depending on which specific agent is used. These medications do not come without the potential of serious side effects. Some side effects include:

  • abnormal cardiac rhythm
  • involuntary facial and body movements, known as tardive dyskinesia
  • weight gain
  • muscle cramps
  • irritability
  • metabolic abnormalities

Often, other medication classes need to be added to prevent or treat the side effects associated with the antipsychotic medications. These medication classes include anti-cholinergic agents, antidepressants, mood stabilizers and anxiolytic agents such as benzodiazepines.

Caution with benzodiazepine use

Benzodiazepines are known to be sedating and also highly addictive, but they are widely prescribed by many physicians. A recent study published in The American Journal of Psychiatryhas shown that high exposure to benzodiazepines over time can increase premature death in patients with schizophrenia. “The researchers investigated the association between mortality and cumulative exposure to antipsychotics, antidepressants, and benzodiazepines using two Swedish nationwide health care registers. Among roughly 7 million people aged 17 to 64 years, they identified 21,492 patients with schizophrenia, a prevalence of 0.34 percent.”

Study results compared the use of antidepressants, antipsychotics and anxiolytic medications in patients with schizophrenia and determined the mortality and morbidity rates among each of these medication classes. Benzodiazepines proved to increase the morbidity and mortality in patients with schizophrenia in a direct dose-response fashion; the higher the dose, the longer the treatment resulted in increased adverse outcomes. Patients who were exposed to high doses of benzodiazepines had a 70 percent increased risk in death compared to those who were not exposed to this class of anxiolytic medication.

Antidepressants and antipsychotic medications actually improved mortality rates in patients who have schizophrenia compared to patients who have schizophrenia and were not taking either of these two classes of medications. The study results concluded that when initiating benzodiazepine therapy in patients with schizophrenia, the duration should not exceed greater than one month. Long-term therapy for anxiety should be treated with antidepressants for those with schizophrenia.

Antipsychotic medication proves effective

Schizophrenia affects approximately 1 percent of people worldwide and often presents in the second decade of life. It is characterized by hallucinations and delusions for a duration of a minimum of six months and can have drastic effects on individuals and their loved ones. Treatment is attainable but usually takes a few changes to the medication regimens for symptoms to subside without drastic side effects.

As with many patients, it took Kurt Snyder years to find a medication regimen that worked well for him. “I have continued to notice steady improvement in my condition over the last three years, both for positive and negative symptoms. I now believe that I have fully recovered from schizophrenia, and I realize that my recovery is owed entirely to medication. I now experience no delusions, no paranoia, and I do not have bizarre thoughts.”

This study is just one of many with new and helpful information that can be used to limit the harmful effects medications can have on patients diagnosed with mental illnesses.

Sovereign Health of California treats individuals with behavioral health disorders, including mental health problems like schizophreniasubstance abuse and co-occurring disorders. To learn more about our evidence-based treatment programs, please call our 24/7 helpline.

About the author

Kristen Fuller, M.D., is a senior staff writer at Sovereign Health Group and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at


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