Antipsychotics and mood stabilizers are widely used for the treatment of several psychiatric disorders including schizophrenia, bipolar disorder, depression, borderline personality disorder, and others. In 2007 an estimated 3.9 million Americans purchased antipsychotics which was a three time increase within 10 years. Similarly, other countries such as the U.K. and Australia followed this trend as well. Most of these antipsychotics have been studied in clinical trials for their effectiveness in reducing relapse and readmission rates, however, there are barely any studies on their effect on reducing violent behavior. Violent behavior either to oneself or to others is a characteristic of psychiatric disorder. This violent behavior can eventually lead to violent crimes which means that psychiatric disorders can be linked to violent crime. Clinical studies show that antipsychotics are effective in treating mental disorders but there is little evidence that drugs actually reduce violent crimes. It is not only important to measure the outcome of relapse or admission but also improvement in violent behavior.
Antipsychotics, Mood Stabilizers, and Reduction in Violent Crime
A recent study was published on May 8, 2014 about use of antipsychotics and mood stabilizers and the reduction in violent crime. This study included 82,647 men and women who were prescribed an antipsychotic or mood stabilizer during the years 2006 to 2009. This data was obtained from the Swedish Prescribed Drug Register. The study also used data from the national crime register to compare the rate of violent crime when the patient was not on medication and when the patient was receiving treatment. Violent crime included conviction for homicide, assault, robbery, arson, any sexual offense illegal threats, or intimidation. The results of this study showed that violent crime fell by 45% in patients receiving treatment with antipsychotics and 24% in patients receiving treatment with mood stabilizers. Mood stabilizers were associated with reduced rate of violent crime only in those diagnosed with bipolar disorder. The study also noted that treatment with higher dosage antipsychotics showed a greater reduction in violent crime than lower doses. This did not hold true for mood stabilizers. Overall, the study found that violent crime fell by about 64% in patients taking any antipsychotic or mood stabilizer.
A previous study also looked at how antipsychotics affect violent behavior in patients with schizophrenia. In this small clinical study, data was obtained by observing 229 patients over a 2 year period in a North Carolina mental health system. This study found that 36.4% of the patient in the group not treated with antipsychotic showed violence compared to 13% of the patients treated with antipsychotics.
In conclusion, the data in this study showed that patients with a psychiatric disorder that are treated are less likely to commit violent crime. Even though this study looked at a patient population in Sweden, it can be generalized to the United States and other countries The trend in both Sweden and the United States both showed increases in the amount of people that are prescribed antipsychotics or mood stabilizers. In addition, the violent crime rates in both countries are similar to each other. This study is the first total population-based study that focuses on how antipsychotics and mood stabilizers can reduce the risk of violent crime. Is it possible that appropriate treatment of psychiatric conditions can reduce violence in society and reduce incarceration.
Seena Fazel, Johan Zetterqvist, Henrik Larsson, Niklas Långström, Paul Lichtenstein. Antipsychotics, mood stabilizers, and risk of violent crime. The Lancet - 8 May 2014
Swanson, Jeffrey W., Marvin S. Swartz, and Eric B. Elbogen. Effectiveness of Atypical Antipsychotic Medications in Reducing Violent Behavior Among Persons With Schizophrenia in Community-Based Treatment. Schizophrenia Bulletin, 2004. Web. 03 June 2014.