The potential role of antipsychotic treatment in affecting suicide rates and in explaining the increased mortality due to somatic disorders is still debated. The aim of this study was to assess mortality in individuals who were prescribed typical and atypical neuroleptics in one voivodship in Poland.

We conducted a retrospective cohort study involving 84881 patients who had drug insurance benefits in Pomeranian voivodship and who began receiving a conventional or atypical antipsychotic medication between 2008 and 2012. Data on deaths in this population have been collected from National Death Registry. Age-standardized death rates were calculated in the adult population exposed population to any dose of atypical antipsychotic medication, in popualtion of users of atypical antipsychotics only, in population of users of conventional antipsychotic drugs only and in population of clozapine users.

In individuals who were prescribed conventional antipsychotic medication age-standardized death rate was significantly higher than in ever users of atypical medicatioons and people using only atypical drugs: 69.6 per 1000, 95% confidence interval (95% CI) 67.64–71.56 compared with 53.24 per 1000, 95% CI 50.8–55.69 and 48,38 per 1000, 95% CI 44.78–51.98. Mortality rate in clozapine users was also higher than in users oaf atypical medications (65,11 per 1000, 95% CI 50.8–55.69).

These results suggest that conventional antipsychotic medications are associated with increased risk of death compared to atypical drugs. Analysis based on administrative record linkage is the major limitation of this study. No adjustment has been made for confounding factors that may modify mortality risk.