Antipsychotics and Risk for Sudden Cardiac Death

Epidemiologic studies have shown dose-related increases in sudden cardiac death with typical antipsychotic drugs. Less is known about the risk with the newer atypical agents, which have mostly supplanted older agents and are increasingly used off-label for medication-refractory depression and, in low doses, for sleep, anxiety, and agitation. In a careful epidemiologic study of Tennessee Medicaid data, researchers examined the risk for sudden cardiac death in 93,300 users and 186,600 nonusers of antipsychotic drugs. Typical agents were haloperidol and thioridazine; atypical agents were clozapine, olanzapine, risperidone, and quetiapine.

Overall, the risk for sudden cardiac death was 17.9 per 10,000 patient-years, higher in men and older indiv…