Do antipsychotics help people with schizophrenia get back to work or school?

When someone is diagnosed with schizophrenia, a huge question is whether treatment will help them get back to their life—to a job or an education. A long-term study followed over 65,000 people in Denmark with schizophrenia for more than two decades to see how antipsychotic medication related to this 'productive engagement.' The findings were nuanced and changed over time. In the acute and consolidation phases (the first five years after diagnosis), taking antipsychotics was associated with reduced rates of being in work or education. However, in the long-term maintenance phase (after five years), the association flipped to a small positive one. The researchers used a within-person analysis to try to account for individual differences, but this is still an observational study. It can't prove the medication caused the changes; it only shows they were linked over time. The study also noted that relying only on community pharmacy records can miss some medication use, which is a limitation for this kind of research. Overall, the picture is that the relationship between medication and functional recovery is not simple or static—it appears to shift across different phases of a person's journey with schizophrenia.