Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schizophrenia
If quetiapine is meant to prevent relapse of a psychotic disorder, is there a reason to prefer it over options with stronger real-world track records?
Suggestive but preliminary. Not settled. how we score evidence
Caveat on this rating: Funded by Janssen-Cilag, which markets competing antipsychotics (paliperidone, risperidone), though the funder reportedly had no role in design or analysis; observational design cannot fully exclude confounding by indication.
Following 29,823 Swedish patients with schizophrenia for up to 7.5 years, oral quetiapine had the highest rehospitalization risk of the commonly used antipsychotics — barely better than taking no antipsychotic at all (hazard ratio 0.91) and roughly 40-70% worse than clozapine or long-acting injectables.
Worth asking
If quetiapine is meant to prevent relapse of a psychotic disorder, is there a reason to prefer it over options with stronger real-world track records?
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Schizophrenia (adults; adolescents 13-17)
- Bipolar I disorder, acute manic episodes (monotherapy or adjunct to lithium/divalproex; ages 10-17 monotherapy)
- Bipolar disorder, acute depressive episodes (monotherapy) · trials ran 8-week randomized trials
- Bipolar I disorder, maintenance treatment (adjunct to lithium or divalproex)
- Major depressive disorder, adjunctive treatment with antidepressants (Seroquel XR only)
Source
Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schizophrenia — Tiihonen J, et al. (2017)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1001/jamapsychiatry.2017.1322
DOI: 10.1001/jamapsychiatry.2017.1322
How this was scored
- Study design
- Cohort study
- Funding
- Industry funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 29,823
- Preregistered
- No
- Conflicts disclosed
- Yes
- Independent of proponent
- No
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "early signal". Suggestive but preliminary. Not settled. It scores 49 out of 100 on our published rubric. One caveat travels with that badge: Funded by Janssen-Cilag, which markets competing antipsychotics (paliperidone, risperidone), though the funder reportedly had no role in design or analysis; observational design cannot fully exclude confounding by indication. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Real-World Effectiveness of Antipsychotic Treatments in a Nationwide Cohort of 29 823 Patients With Schizophrenia — Tiihonen J, et al. (2017). Published in: Top-tier peer-reviewed journal. DOI: 10.1001/jamapsychiatry.2017.1322. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cohort study. Funding: Industry funded. The researchers were not independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is quetiapine (Seroquel), seroquel FDA approved?
Yes — FDA approved for Schizophrenia (adults; adolescents 13-17), Bipolar I disorder, acute manic episodes (monotherapy or adjunct to lithium/divalproex; ages 10-17 monotherapy), Bipolar disorder, acute depressive episodes (monotherapy), Bipolar I disorder, maintenance treatment (adjunct to lithium or divalproex), Major depressive disorder, adjunctive treatment with antidepressants (Seroquel XR only). Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.