Psychotropic medications may cut risk of violent reoffending

Prescribing ex-prisoners psychotropic medications after release is associated with a decrease in reoffending, according to a new study led by the University of Oxford.

The researchers looked at released prisoners from across Sweden between 2005 and 2010, who were prescribed antipsychotics, psychostimulants and drugs for addictive disorders, and followed until end of 2013. By comparing the periods when they were and were not prescribed these medications, the researchers were able to show a drop in the rate of violent reoffending while they were receiving treatment.

Of the 22,275 released prisoners in the study, 4,031 committed violent re-offences in the follow-up period, amounting to 5,653 individual incidents. Antipsychotic medications were associated with a 42% reduction in the rate of violent reoffending, psychostimulants with a 36% reduction in this rate, and for drugs used in addictive disorders there was 52% drop. No significant reductions were found for antidepressants or antiepileptic medications.

The study, published in the Journal of the American Medical Association, raises the possibility that prescribing psychotropic medications to individuals considered at particular risk offers a way of helping to re-integrate individuals into society, who may otherwise become trapped in a cycle of reoffending.

Wellcome Senior Research Fellow Professor Seena Fazel of the University of Oxford's Department of Psychiatry, who led the research, said: 'Many countries are keen to reduce the number of people in their prisons, but are unsure how to balance rehabilitation with protecting the public. This study raises the possibility that prescribed medications may provide a way to cut the risk of violent reoffending, as part of a wider package of support.

'The research also highlighted that medications seem to work beyond their immediate effects on symptoms. We have shown that in a population with many mental health problems and high risks of reoffending, improving adherence and links with community health services may offer an effective way to improve outcomes for the individual prisoner and also public health and safety more broadly.'

The research team from the universities of Oxford, Örebro, Uppsala and the Karolinska Institutet, noted that further research is now needed to understand the nature of the association.