3 common drugs associated with reduced risk of hospitalization and harm in serious mental illness

Statins, calcium-channel blockers, and metformin are globally licensed, commonly used, inexpensive, and relatively safe, and therefore “ideal candidates for repurposing” for mental illness, the study authors wrote.


Three drug classes commonly prescribed for high cholesterol, hypertension, or diabetes were associated with reduced rates of psychiatric hospitalization and self-harm in individuals with serious mental illness, a Swedish observational study found.

To explore repurposing statins, calcium-channel blockers, and metformin for serious mental illness, researchers conducted within-individual cohort studies based on national health care registries. The study included 142,691 patients with bipolar disorder (n=76,759), schizophrenia (n=30,954), or nonaffective psychosis (n=34,978) who were 15 years of age or older and treated with psychiatric medication from October 2005 through December 2016. Results were published Jan. 9 by JAMA Psychiatry.

Exposure to any of the study drugs was associated with reduced rates of psychiatric hospitalization compared with unexposed periods, the authors wrote. Statins were associated with reduced rates of psychiatric hospitalization in bipolar disorder (adjusted hazard ratio [HR], 0.86; 95% CI, 0.83 to 0.89; P<0.001), schizophrenia (adjusted HR, 0.75; 95% CI, 0.71 to 0.79; P<0.001), and nonaffective psychosis (adjusted HR, 0.80; 95% CI, 0.75 to 0.85; P<0.001), as well as reduced rates of self-harm in bipolar disorder (adjusted HR, 0.76; 95% CI, 0.66 to 0.86; P<0.001) and schizophrenia (adjusted HR, 0.58; 95% CI, 0.45 to 0.74; P<0.001).

Calcium-channel blockers were associated with reduced rates of psychiatric hospitalization and self-harm in subgroups with bipolar disorder (adjusted HRs, 0.92 [95% CI, 0.88 to 0.96; P<0.001] and 0.81 [95% CI, 0.68 to 0.95; P=0.01], respectively), schizophrenia (adjusted HRs, 0.80 [95% CI, 0.74 to 0.85; P<0.001] and 0.30 [95% CI, 0.18 to 0.48; P<0.001], respectively), and nonaffective psychosis (adjusted HRs, 0.89 [95% CI, 0.83 to 0.96; P=0.002] and 0.56 [95% CI, 0.42 to 0.74; P<0.001], respectively).

Metformin was associated with reduced rates of psychiatric hospitalization in subgroups with bipolar disorder (adjusted HR, 0.80; 95% CI, 0.77 to 0.84; P<0.001), schizophrenia (adjusted HR, 0.73; 95% CI, 0.69 to 0.77; P<0.001), and nonaffective psychosis (adjusted HR, 0.85; 95% CI, 0.79 to 0.92; P<0.001), as well as a reduction in self-harm in bipolar disorder (adjusted HR, 0.73; 95% CI, 0.62 to 0.84; P<0.001) and schizophrenia (adjusted HR, 0.64; 95% CI, 0.48 to 0.85; P<0.001).

The researchers wrote that there is a theoretical basis for these drug classes effectively reducing psychiatric symptoms and that their effects on the central nervous system should be studied. They noted that all three are “are globally licensed, commonly used, cheap, and relatively safe medications. They are therefore ideal candidates for repurposing.”