Psychiatrists have worried that medications for schizophrenia could improve mental health at the cost of physical health and life expectancy, but new research shows those worries are unfounded.

A new study published today in the journal Schizophrenia Bulletin shows that schizophrenics who stick rigidly to a drug regimen and who see mental health professionals on a regular basis live longer than those who don’t.

“We know that antipsychotic medications reduce symptoms, and our study shows that staying on reasonable, recommended doses is associated with longer life,” said Dr. Bernadette Cullen, lead author of the study and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “The same is true for going to see a psychiatrist or therapist.”

The study looked at 2,132 adult Maryland Medicaid recipients with schizophrenia from 1994 to 2004. Researchers noted how much medication the patients took, how regularly they took it, and how often they visited mental health professionals. They found that patients who had a 90% or better compliance rate with their medication schedules had a 25% lower risk of death than those who were less than 10% compliant. Also, each additional visit per year to a mental health professional was linked to a 5% overall reduction to the risk death.

A moderate amount of antipsychotic medication seems to be key, though. The researchers found that patients who took “high” doses of first-generation (typical) antipsychotic medication were 88% more likely to die. Cullen pointed out that this result could be because first-generation antipsychotics have been associated with heart disease, and that 53% of those patients who died while taking larger doses died of cardiovascular disease.

“These drugs work very well, but there is clearly a point of diminishing returns,” said Cullen. “You rarely need to be on extremely high doses. If people are taking their medications, they usually have fewer symptoms and are able to be more organized in other areas of their lives. We believe they are then more likely to make appointments with their primary care doctors, to stay on top of other illnesses they may have and to regularly take diabetes, blood pressure or cholesterol medication that they may require to stay healthy. We also believe that they are more likely to be socially engaged and have a healthier lifestyle.”