Does thioridazine increase the risk of sudden unexplained death in psychiatric in-patients?
Thioridazine use in psychiatric inpatients is associated with a more than 5-fold increased risk of sudden unexplained death, likely due to drug-induced arrhythmia.
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 drug-induced arrhythmia.
Reilly et al. (Sat,) studied this question.