HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Related articles in BJP Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by REILLY, J. G. Articles by THOMAS, S. H. L. Search for Related Content PubMed PubMed Citation Articles by REILLY, J. G. Articles by THOMAS, S. H. L.

Thioridazine and sudden unexplained death in psychiatric in-patients

Academic Department of Psychiatry, University of Newcastle upon Tyne

S. A. AYIS, PhD

Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne

I. N. FERRIER, FRCPsych

Academic Department of Psychiatry, University of Newcastle upon Tyne

S. J. JONES, RGN and S. H. L. THOMAS, MD

Wolfson Unit of Clinical Pharmacology, University of Newcastle upon Tyne

Correspondence: Dr S. H. L. Thomas, Wolfson Unit of Clinical Pharmacology, University of Newcastle, Newcastle NE2 4HH, UK. Tel: 0191 222 8094; fax: 0191 261 5733; e-mail: simon.thomas{at}ncl.ac.uk

Declaration of interest None.

See editorial, pp. 483–484, this issue.

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 druginduced arrythmia.

Related articles in BJP:

Highlights of this issue

MARY CANNON
BJP 2002 180: 0. [Full Text]  

Antipsychotics and sudden death: is thioridazine the only bad actor?

WAYNE A. RAY and KEITH G. MEADOR
BJP 2002 180: 483-484. [Full Text]  

This article has been cited by other articles:

				S. Kisely, M. Smith, D. Lawrence, M. Cox, L. A. Campbell, and S. Maaten Inequitable access for mentally ill patients to some medically necessary procedures Can. Med. Assoc. J., March 13, 2007; 176(6): 779 - 784. [Abstract] [Full Text] [PDF]

				N. Abdelmawla and A. J. Mitchell Sudden cardiac death and antipsychotics. Part 1: Risk factors and mechanisms Advan. Psychiatr. Treat., January 1, 2006; 12(1): 35 - 44. [Abstract] [Full Text] [PDF]

				C. Griffiths and R. J. Flanagan Fatal poisoning with antipsychotic drugs, England and Wales 1993-2002 J Psychopharmacol, November 1, 2005; 19(6): 667 - 674. [Abstract] [PDF]

				J. K. Schulman, P. R. Muskin, and P. A. Shapiro Psychiatry and Cardiovascular Disease Focus, April 1, 2005; 3(2): 208 - 224. [Abstract] [Full Text] [PDF]

				S. M. J. M. Straus, G. S. Bleumink, J. P. Dieleman, J. van der Lei, G. W. 't Jong, J. H. Kingma, M. C. J. M. Sturkenboom, and B. H. C. Stricker Antipsychotics and the Risk of Sudden Cardiac Death Arch Intern Med, June 28, 2004; 164(12): 1293 - 1297. [Abstract] [Full Text] [PDF]

				D. RUSCHENA, P. E. MULLEN, S. PALMER, P. BURGESS, S. M. CORDNER, O. H. DRUMMER, C. WALLACE, and J. BARRY-WALSH Choking deaths: the role of antipsychotic medication The British Journal of Psychiatry, November 1, 2003; 183(5): 446 - 450. [Abstract] [Full Text] [PDF]

				H. J. Witchel, J. C. Hancox, D. J. Nutt, and S. Wilson Antipsychotics, HERG and sudden death The British Journal of Psychiatry, February 1, 2003; 182 (2): 171 - 172. [Full Text] [PDF]

				W. A. RAY and K. G. MEADOR Antipsychotics and sudden death: is thioridazine the only bad actor? The British Journal of Psychiatry, June 1, 2002; 180(6): 483 - 484. [Full Text] [PDF]