Thioridazine and sudden unexplained death in psychiatric in-patients.
BACKGROUND
Sudden death has been linked to antipsychotic therapy, but the relative risk associated with specific drugs is unknown.


OBJECTIVE
To assess the risk of sudden unexplained death associated with antipsychotic drug therapy and its relation to drug dose and individual agents.


METHODS
A case-control study of psychiatric in-patients dying suddenly in five hospitals in the north-east of England and surviving controls matched for age, gender and mental disorder. Logistic regression analysis was used to identify significant risk factors, and odds ratios were calculated.


RESULTS
Sixty-nine case-control clusters were identified. Probable sudden unexplained death was significantly associated with hypertension, ischaemic heart disease and current treatment with thioridazine (adjusted odds ratio=5.3, 95% CI 1.7-16.2, P=0.004). There was no significant association with other individual antipsychotic drugs.


CONCLUSIONS
Thioridazine alone was associated with sudden unexplained death, the likely mechanism being drug-induced arrhythmia.
Reilly
J G
JG
Academic Department of Psychiatry, University of Newcastle upon Tyne.
Ayis
S A
SA
Ferrier
I N
IN
Jones
S J
SJ
Thomas
S H L
SH
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology*; D004305:Dose-Response Relationship, Drug; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012044:Regression Analysis; D012307:Risk Factors; D013881:Thioridazine / Q000009:adverse effects*
D014150:Antipsychotic Agents; D013881:Thioridazine