Choking deaths: the role of antipsychotic medication.
BACKGROUND
An increased risk of choking associated with antipsychotic medication has been repeatedly postulated.


OBJECTIVE
To examine this association in a large number of cases of choking deaths.


METHODS
Cases of individuals who had died because of choking were linked with a case register recording contacts with public mental health services. The actual and expected rates of psychiatric disorder and the presence of psychotropic medication in post-mortem blood samples were compared.


RESULTS
The 70 people who had choked to death were over 20 times more likely to have been treated previously for schizophrenia. They were also more likely to have had a prior organic psychiatric syndrome. The risk for those receiving thioridazine or lithium was, respectively, 92 times and 30 times greater than expected. Other antipsychotic and psychotropic drugs were not over-represented.


CONCLUSIONS
The increased risk of death in people with schizophrenia may be a combination of inherent predispositions and the use of specific antipsychotic drugs. The increased risk of choking in those with organic psychiatric syndromes is consistent with the consequences of compromised neurological competence.
Department of Psychological Medicine, Monash University, Victoria, Australia.
D
D
Ruschena
P E
PE
Mullen
S
S
Palmer
P
P
Burgess
S M
SM
Cordner
O H
OH
Drummer
C
C
Wallace
J
J
Barry-Walsh
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000402:Airway Obstruction / Q000139:chemically induced / Q000401:mortality*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008094:Lithium / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000188:drug therapy / Q000401:mortality; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000401:mortality; D017678:Sex Distribution; D013881:Thioridazine / Q000009:adverse effects
D014150:Antipsychotic Agents; D008094:Lithium; D013881:Thioridazine