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Forensic Analysis of 24 Cases of Long-term Antipsychotics Use-Induced Sudden Unexpected Deaths
1Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
Objectives:
To analyze the forensic characteristics of 24 psychiatric patients who died of long-term use of psychotropic drugs.
Methods:
Cases of sudden death of psychiatric patients from 2011 to 2016 were collected. The forensic characteristics of these sudden deaths were retrospectively analyzed by systematic investigation plus results of autopsy and toxics (drugs).
Results:
Among the 24 psychiatric patients who died of long-term use of psychotropic substances, the ratio of male to female was 1.7∶1, and the average age was (59.0±8.8) years. Fifteen patients had clear disease durations (14.4±8.2) years, and other the nine were known to have disease durations of over 3 years. The death time of 62.5% of patients was the daytime in working days, and 91.7% of the patients died at home. Most patients complained different degrees of physical discomfort before death. Patients with schizophrenia (20 cases) were the most common, followed by depression (4 cases). All patients had the history of taking psychotropic drugs, with clozapine and chlorpromazine being the mostly detected ones. The causes of death were mainly circulatory diseases (15 cases), with the most common being myocarditis (11 cases) followed by pneumonia (4 cases).
Conclusions:
Critical attention should be paid to the risk of antipsychotics-induced sudden unexpected deaths for psychiatric patients, particularly for those with schizophrenia.
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