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Antipsychotics Increase Risks for Sudden Cardiac Death

Antipsychotic drugs — both typical and atypical — carry significant risks for sudden cardiac death, and their use in some patients should be sharply reduced, according to a study and editorial in the New England Journal of Medicine.

Using 16 years of Tennessee Medicaid data, researchers retrospectively examined rates of sudden cardiac death occurring in the community in the following groups: patients currently taking typical antipsychotic drugs, patients taking atypical antipsychotics, and controls.

The principal findings were:

• Current users of both typical and atypical antipsychotics showed a doubling in risk for sudden death relative to controls.
  
• Risk increased with increasing dose among current users.
  
• Former users showed no increased risk relative to controls.
  

Editorialists conclude that, especially among children and demented elderly patients for whom there is little evidence of the drugs' efficacy, their use "should be reduced sharply."

LINK(S):

NEJM article (Free abstract; full text requires subscription)

NEJM editorial (Subscription required)

Physician's First Watch coverage of Lancet study on antipsychotic use in AD (Free)

Journal Watch Psychiatry and Journal Watch Cardiology summary (Subscription required)

Journal Watch General Medicine summary (Free)

Published in Physician's First Watch January 15, 2009