In this large case-control study, rates of sudden cardiac death were twice as high in anti-psychotic users (versus non-users) with a significant dose-response relationship (abstract). For typical anti-psychotics, incidence rate ratios of death (compared to nonusers) were 1.3 (low dose) to 2.4 (high dose). For atypical agents, the ratios of death were 1.6 (low dose) to 2.9 (high dose). This study reminds us that both typical and atypical anti-psychotics have been associated with an increase the risk of sudden cardiac death. Although causality has not be proven, their use (and dose) should be minimized (if possible) in the inpatient setting.
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.