Key result
Compared to olanzapine, chlorpromazine (HR 2.06) and haloperidol (HR 1.72) were associated with higher risks of sudden cardiac death and ventricular arrhythmia, while quetiapine had lower risk.
Why the study?
Does the choice of antipsychotic affect the risk of sudden cardiac death, ventricular arrhythmia, and all-cause death in incident antipsychotic users?
Population
459,614 incident antipsychotic users aged 30-75 years in Medicaid programs of California, Florida, New York…
Comparison
Antipsychotics vs Olanzapine
Design
Cohort
Authors
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Certain antipsychotics may raise SD/VA risk versus others; leaves open causal effects and optimal selection.
Cohort (n=459,614)
Yes
Does the choice of antipsychotic affect the risk of sudden cardiac death, ventricular arrhythmia, and all-cause death in incident antipsychotic users?
Hazard Ratio: 2.06 (95% CI 1.2–3.53)
Haloperidol and chlorpromazine are associated with higher risks of sudden cardiac death and ventricular arrhythmia compared to olanzapine, while quetiapine is associated with a lower risk, suggesting average QT prolongation is a poor surrogate for arrhythmogenicity.
Charles E. Leonard (2012) conducted a cohort in Incident antipsychotic users (n=459,614). Antipsychotics (chlorpromazine, haloperidol, quetiapine, perphenazine, risperidone) vs. Olanzapine was evaluated on Incident, first-listed emergency department or principal inpatient sudden cardiac death and ventricular arrhythmia (SD/VA) diagnoses (HR 2.06, 95% CI 1.20-3.53). Compared to olanzapine, chlorpromazine (HR 2.06) and haloperidol (HR 1.72) were associated with higher risks of sudden cardiac death and ventricular arrhythmia, while quetiapine had lower risk.
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