Anti-psychotic drugs may halve violent crime rates

People who use anti-psychotic drugs to treat psychiatric illness are nearly half as likely to commit a violent crime compared to when they are not using such medication, a new Oxford study has claimed.
The use of mood stabilising drugs is also associated with a reduced rate of violent crime, although the reduction is less pronounced, and only in patients with bipolar disorder, researchers said.
Anti-psychotic and mood stabilising medication are used to treat a variety of disorders, but are most commonly associated with the treatment of schizophrenia, bipolar disorder, and related disorders that affect up to 2 per cent of the general population.

Although evidence suggests that people who use these medications are at less risk of relapse and re-hospitalisation for their illness, until now, there has been very little evidence for these drugs' effects on real-world adverse outcomes, such as reducing violent behaviour, despite increasing prescription rates in many countries.
A team of researchers led by Dr Seena Fazel of Oxford University used Swedish national health registries to study the psychiatric diagnoses, and any subsequent criminal convictions, in over 80,000 patients (40,937 men and 41,710 women) who were prescribed anti-psychotic or mood stabilising medication, from 2006 to 2009.
In the three years studied, 6.5 per cent (2657) of the men, and 1.4 per cent (604) of women were convicted of a violent crime.

Compared with periods when participants were not on medication, violent crime fell by 45 per cent in patients receiving anti-psychotics, and by 24 per cent in patients prescribed mood stabilisers.

Although the two types of medication are often combined, the researchers found no evidence that combining the drugs has any further effect on reducing violent crime, and for patients prescribed mood stabilisers, the medication was associated with reductions in violent crime only in male patients with bipolar disorder.
Moreover, although anti-psychotic and mood stabilising medications are generally associated with treatment of schizophrenia or bipolar disorder, the researchers found that many people in the study were prescribed these drugs for other disorders, such as depression or alcohol and drug misuse.

"Patients with psychiatric disorders are at risk of perpetrating violent acts, as well as being victims. Until now, we have not known whether anti-psychotics and mood stabilisers reduce risks of violence," said Fazel.
"By comparing the same people when they are on medication compared to when they are not, our study provides evidence of potentially substantial reductions in risk of violence, and suggests that violence is to a large extent preventable in patients with psychiatric disorders," Fazel said.
The study was published in The Lancet journal.