Antipsychotics, Mood Stabilizers May Reduce Violent Crime

A study in Sweden found that violent crime rates were reduced by 45% among patients with psychiatric disorders who were prescribed antipsychotics.

In addition to treating symptoms of psychiatric illness, antipsychotics and mood stabilizers may also help to reduce violent behaviors among patients with psychiatric disorders, the results of a recent study conducted in Sweden suggest.

The study, published online on May 8, 2014, in The Lancet, analyzed data from national register to evaluate the effect of antipsychotics and mood stabilizers on the rate of violent crime committed by patients with psychiatric disorders in Sweden. The researchers of the study looked at the criminal records of 82,647 patients aged 15 years and older before and after they were prescribed antipsychotics or mood stabilizers.

From 2006 to 2009, 6.5% of men and 1.4% of women taking antipsychotics or mood stabilizers were convicted of a violent crime. When patients took any antipsychotic medication or mood stabilizer, the rate of violent crime fell by 64%, when compared with periods when patients were not on the medications. Violent crimes decreased by 45% among patients prescribed antipsychotics and by 24% among those prescribed mood stabilizers. The association was significant in both male and female patients prescribed antipsychotics to treat schizophrenia, bipolar disorder, and other psychoses. Mood stabilizers, however, were only associated with decreased rates of violent crime among male patients diagnosed with bipolar disorder.

In addition, the relationship between medication and reduced rates of violence was stronger among patients prescribed higher doses of antipsychotics. Higher doses of mood stabilizers, however, did not significantly change the rate of violence reduction. Depot medication also significantly reduced the rate of violent crime among patients after adjusting for oral antipsychotics and mood stabilizers. The results also indicated that adding an antipsychotic to the medication regimen of patients already taking mood stabilizers was associated with a significant decrease in the rate of violent crime, while adding a mood stabilizer to treatment with antipsychotic medications had no significant effect on the rate of violence. This finding is particularly important, the study authors note, considering that the medications are often prescribed together, although evidence proving the efficacy of the combination is lacking.

“Although a direct causal interpretation is not possible, these associations might have important implications for clinical practice,” the authors of the study write. They suggest that the findings may not be applicable in other countries and that more research is needed to explore the effect of the medications on violent behavior.

“[This] well executed study provides a basis for future clinical studies aiming to establish how antipsychotics and mood stabilisers can be used to reduce aggressive behavior,” an accompanying editorial reads. “The study illustrates again that de-identified data from national registers that were established for administrative reasons can be used by epidemiologists to identify potential strategies to reduce health-related social problems.”