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The British Journal of Psychiatry (2002) 180: 515-522
© 2002 The Royal College of Psychiatrists

Thioridazine and sudden unexplained death in psychiatric in-patients{dagger}

J. G. REILLY, MRCPsych

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.

{dagger} 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.


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