What Is the Risk for Unexpected Death Among Children and Youths Taking Antipsychotics?

Although the antipsychotic thioridazine was initially considered “virtually free of side effects,” it later accumulated black-box warnings, including for sudden death. Today, concerns about safety have grown with increased prescriptions of antipsychotic drugs in youth, particularly for off-label use. Focusing on off-label antipsychotic use, investigators used Medicaid data on 5- to 24-year-olds to retrospectively compare deaths (unexpected or due to injury or suicide) in individuals with first prescriptions of psychotropic medication but without schizophrenia spectrum psychoses or tic disorders. Antipsychotic doses were stratified as “higher” and “lower” (median cut-point, 50-mg chlorpromazine equivalents).

There were 28,377 people in the lo…