I use moderately toxic medications when I treat people with schizophrenia. Not highly dangerous — akin to the immunosuppressants, interferons, or antineoplastic medications that exist — but medications with significant side effects.
Some people ask why. The simple answer is that the psychotic disorders shorten life and cause disability.
Adults with schizophrenia were more than 3.5 times (all-cause SMR, 3.7; 95% CI, 3.7-3.7) as likely to die in the follow-up period as were adults in the general population. Cardiovascular disease had the highest mortality rate (403.2 per 100?000 person-years) and an SMR of 3.6 (95% CI, 3.5-3.6). Among 6 selected cancers, lung cancer had the highest mortality rate (74.8 per 100?000 person-years) and an SMR of 2.4 (95% CI, 2.4-2.5). Particularly elevated SMRs were observed for chronic obstructive pulmonary disease (9.9; 95% CI, 9.6-10.2) and influenza and pneumonia (7.0; 95% CI, 6.7-7.4). Accidental deaths (119.7 per 100?000 person-years) accounted for more than twice as many deaths as suicide (52.0 per 100?000 person-years). Nonsuicidal substance-induced death, mostly from alcohol or other drugs, was also a leading cause of death (95.2 per 100?000 person-years).
The disorders that particularly are worth considering are the influenzae/ pneumonia. Because they generally are acute, require that a doctor recognises the condition, and respond to rapid treatment. Delays in accessing doctors or not having a primary care doctor increase the mortality. And you see this in this group — who also generally smoke more than the general population, and thus get COPD and lung cancer.
But the psychoses themselves are as great a risk as smoking. And much more of a risk than the associations mentioned in the press about bacon, or coffee, or alcohol.
Severe disorder within the mind almost always is matched by severe disorder in the rest of the body. This is normally compounded by the reality that the suffering patient will have built up habits that might, at the time, have limited the symptoms at they were increasing. (This is why drugs can be so lethal to those people.)
In the case of schizophrenia, it’s also important to remember what is happening at the functional level. They can’t “block out” information that the brain normally would. Thus the body is going to be leeched of anything that can be found to preserve the necessary functions within the brain. When the nervous system is pressed for energy, it will start breaking down the rest of the body in the same way muscle is lost when one is protein deficient.
It’s a pretty terrible thing when the body is attacking itself to survive. Brutal.