Common drugs may benefit patients with serious mental disorders

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Takeaway

  • Patients with serious mental illnesses (SMIs) who were exposed to drugs used to treat common physical health problems such as hypertension (HTN), high cholesterol, and diabetes had significantly lower rates of psychiatric hospitalization in all SMI categories and reduced self-harm in bipolar disorder and schizophrenia.

Why this matters

  • The drugs analyzed in this study—hydroxylmethyl glutaryl coenzyme A reductase inhibitors (HMG-CoA RIs), L-type calcium channel (LTCC) antagonists, and biguanides—are widely available, safe, and could be repurposed in patients with SMI.

Study design

  • Series of within-individual cohort studies (bipolar disorder [BPD]/schizophrenia/nonaffective psychosis [NAP]; n=142,691).
  • Funding: Wellcome Trust; others.

Key results

  • Lower rates of psychiatric hospitalization/self-harm were noted with exposure to:
  • HMG-CoA RIs:
    • psychiatric hospitalization (P<.001>
    • BPD: aHR, 0.86;
    • schizophrenia: aHR, 0.75; and
    • NAP: aHR, 0.80.
  • self-harm (P<.001>
  • BPD: aHR, 0.76; and
  • schizophrenia: aHR, 0.58.
  • LTCC antagonists:
    • psychiatric hospitalization and self-harm:
      • BPD: aHRs, 0.92 (P<.001 respectively>
      • schizophrenia: aHRs, 0.80; 0.30 (both, P<.001 respectively and>
      • NAP: aHRs, 0.89 (P=.002); 0.56 (P<.001 respectively.>
  • Biguanides:
    • psychiatric hospitalization (P<.001>
    • BPD: aHR, 0.80;
    • schizophrenia: aHR, 0.73; and
    • NAP: aHR, 0.85.
  • self-harm (P<.001>
  • BPD: aHR, 0.73; and
  • schizophrenia: aHR, 0.64.
  • Limitations

    • Observational study design.

    Coauthored with Chitra Ravi, MPharm