Anti-psychotics and sudden cardiac death

By  |  January 16, 2009 | 

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.

One Comment

  1. Tara Scheufler, D.O. January 27, 2009 at 7:46 pm - Reply

    We must be very careful not to assume direct (or indirect) causality only from association.

    Remember that patients who are getting the higher dose of antipsychotics have more severe, and therefore more end-stage, dementia. The further advanced dementia is, the greater the risk of death in any given year. Dementia itself is a terminal, progressive condition.

    I don’t think we should autmoatically draw the conclusion that antipsychotics CAUSE a higher risk of death, but there is an ASSOCIATION. What causes that association is simply not known. Studies should try to elicit the this before we jump to such major conclusions about a medical treatment that, in many patients, is no longer an option.

Leave A Comment

About the Author:

Danielle Scheurer
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.

Categories

Related Posts

By  | June 18, 2018 |  0
Fill in the Blanks: Q: “The diagnosis of type 2 MI is associated with a _____ prognosis.  ___% of patients will live five years after their diagnosis.” The answer is a) POOR and b) a staggering 40%. I did not know that. However, what I am aware of is the ambiguity around Type 2 MIs and […]
By  | July 5, 2016 |  0
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
By  | December 3, 2013 |  1
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc.  Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them.  If I am […]