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Thioridazine and sudden unexplained death in psychiatric in-patients
J G Reilly1, S A Ayis, I N Ferrier
1Academic Department of Psychiatry, University of Newcastle upon Tyne.
Background:
Sudden death has been linked to antipsychotic therapy, but the relative risk associated with specific drugs is unknown.
Aims:
To assess the risk of sudden unexplained death associated with antipsychotic drug therapy and its relation to drug dose and individual agents.
Method:
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.