title: Antipsychotic use and unexpected death: a hospital-based case-control study.
abstract: OBJECTIVE
  To examine the risk of unexpected death in patients prescribed an antipsychotic. Unexpected death was defined as death occurring within 7 days of the onset of acute symptoms.
  
  
  METHODS
  A case-control study conducted on events occurring between July 2009 and January 2011 in a UK mental health trust providing in-patient and out-patient services.
  
  
  RESULTS
  The study included 100 cases (deaths) and 436 unmatched controls. Current users of antipsychotics had a lower risk of unexpected death than non-users--adjusted odds ratio (OR) 0.48 (95% CI 0.24-0.94, P = 0.033). A significant reduction in risk was seen for second-generation [adjusted OR 0.42 (95% CI 0.21-0.86, P = 0.018)], but not first-generation agents [adjusted OR 0.83 (95% CI 0.31-2.20, P = 0.706)]. Treatment with antipsychotics for any duration was associated with reduced risk. Dose and route of administration did not affect risk. In a planned secondary analysis not adjusting for cardiovascular disease, prescription of an antipsychotic was not associated with increased risk of unexpected death [adjusted OR 0.56 (95% CI 0.28-1.08, P = 0.084)].
  
  
  CONCLUSIONS
  Our findings do not support an association between current antipsychotic use and increased risk of unexpected death.
authors.affiliation: Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK.|Institute of Pharmaceutical Science, King's College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mace
authors.affiliation: Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK.|Institute of Pharmaceutical Science, King's College London, London, UK.
authors.forename: O
authors.initials: O
authors.lastname: Dzahini
authors.affiliation: Department of Primary Care & Public Health Sciences, School of Medicine, King's College London, London, UK.
authors.forename: V
authors.initials: V
authors.lastname: Cornelius
authors.affiliation: Department of Medicine, Imperial College London, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Anthony
authors.affiliation: Psychological Medicine Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Stewart
authors.affiliation: Pharmacy Department, South London and Maudsley NHS Foundation Trust, London, UK.|Institute of Pharmaceutical Science, King's College London, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Taylor
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003645:Death, Sudden / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
chemical_list: D014150:Antipsychotic Agents
keywords: antipsychotics; mortality; natural cause; unexpected death