title: Medication use and deaths attributed to asphyxia among psychiatric patients.
abstract: In a review of the charts of inpatients who died in 1969-1977 the author found 49 whose death could be attributed to asphyxia. Compared with a matched control group, 48 of the asphyxia patients represented three distinct pathologic categories: 1) older patients with a history of serious physical illness whose deaths appeared unrelated to psychotropic medication use (40%), 2) a group whose deaths were associated with seizures (31%), raising questions about subtherapeutic anticonvulsant levels in association with the use of psychotropic drugs, and 3) a group of patients who choked to death (29%). Choking has been theoretically linked to a combination of dopamine blockade plus strong anticholinergic effects leading to impairment of swallowing. The third category appears to have been virtually eliminated by the use of a drug monitoring system and the Heimlich maneuver.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001237:Asphyxia / Q000523:psychology*; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008607:Intellectual Disability / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000401:mortality; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012559:Schizophrenia / Q000401:mortality
chemical_list: D011619:Psychotropic Drugs