Jari Tiihonen´s research group
Real-world effectiveness of psychopharmacological treatment
Nowadays, most treatment guidelines are largely based on randomized controlled trials (RCTs), but also observational studies can give important contribution to evidence-based medicine. The patient populations in RCTs are highly selected, and follow-up periods are short and, therefore, the generalization of RCTs to real-world settings is questionable. Also, studying infrequent phenomena, such as death and suicide, is practically impossible in RCTs. We study the real-world effectiveness of psychopharmacological treatments of psychoses and depression by using nationwide hospital discharge, prescription and mortality registers.
We have shown that in the treatment of schizophrenia, use of antipsychotic is associated with decreased mortality compared with no use of antipsychotic, and clozapine is associated with lower mortality than other antipsychotics. We have also observed that benzodiazepine use is linked with increased mortality, whereas use of an antidepressant or several concomitant antipsychotics is not. In first episode patients, use of depot antipsychotic injections leads to decreased risk of rehospitalization.
Now we are studying the effectiveness of antipsychotics, mood stabilizers, and antidepressants in the relapse and suicide prevention in dipolar disorders.
- Studies on effectiveness on psychopharmacological treatments of schizophrenia and bipolar disorder
Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study.
BMJ 2006 Jul;333(7561):224
Antidepressants and the risk of suicide, attempted suicide, and overall mortality in a nationwide cohort.
Arch. Gen. Psychiatry 2006 Dec;63(12):1358-67
11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study).
Lancet 2009 Aug;374(9690):620-7
A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia.
Am J Psychiatry 2011 Jun;168(6):603-9
|Antti Tanskanen||Project manager|
|Jari Tiihonen||Research team leader, Professor/specialist physician|