SUDDEN DEATHS OF CHILDREN ON PSYCHOTROPIC DRUGS - COURTESY OF THE EDUCATIONVIEWS WEBSITE

DR FRED BAUGHMAN

Psychotropic medications and the risk of sudden cardiac death during an acute coronary event
Posted by EducationViews.org on January 10, 2012 in Health |

Fred A. Baughman Jr., MD

Abstract:

Aims Psychotropic medication increases cardiac mortality, but the reasons for this association are not clear. We studied the role of psychotropic drugs as a triggering factor of sudden cardiac death (SCD) during an acute coronary event.

Methods and results:
  The use of medication was compared between victims of SCD and survivors of an acute coronary event in a case–control study including a consecutive series of victims of SCD (n= 1814, mean age 65 ± 11 years) verified to be due to an acute coronary event at medico-legal autopsy and consecutive series of patients surviving an acute myocardial infarction (AMI; n= 1171, mean age 66 ± 12 years). The medication history was obtained from autopsy/hospital records and interviews with relatives of SCD victims and AMI patients. The use of antipsychotics [9.7 vs. 2.4%, odds ratio (OR) 4.4, 95% confidence interval (CI) 2.9–6.6; P< 0.001] and antidepressants (8.6 vs. 5.5%, OR: 1.6, 95% CI: 1.2–2.2; P= 0.003) was more common in the SCD than AMI group, but the use of benzodiazepines did not differ between the groups (11.7 vs. 13.2%; P= 0.270). The use of antipsychotics remained as a significant risk factor for SCD after adjustment for confounding variables (OR: 3.4, 95% CI: 1.8–6.5; P< 0.001). Combined use of phenothiazines and any antidepressant was associated with a very high risk of SCD (OR: 18.3, 95% CI: 2.5–135.3; P< 0.001).

 Eur Heart J ehr368 first published online September 14, 2011 doi:10.1093/eurheartj/ehr368

Conclusion:
  The use of psychotropic drugs, especially combined use of antipsychotic and antidepressant drugs, strongly associated with an increased risk of SCD at the time of an acute coronary event.

Re:Psychotropic drugs and sudden death (published December 29, 2011)

Fred A. Baughman Jr., MD, Neurologist (ret) & Mr. Stan White (father of deceased veteran Andrew White)

International Society for Ethical Psychology & Psychiatry (ISEPP)

ABSTRACT FROM EUROPEAN HEART JOURNAL: 

Psychotropic medications and the risk of sudden cardiac death during an acute coronary event

    Jussi Honkola1,
    Eeva Hookana1,
    Sanna Malinen1,
    Kari S. Kaikkonen1,
    M. Juhani Junttila1,
    Matti Isohanni2,
    Marja-Leena Kortelainen3 and
    Heikki V. Huikuri1,*

+ Author Affiliations

    1Department of Internal Medicine, Institute of Clinical Medicine, University of Oulu, PO Box 5000, Oulu 90014, Finland
    2Department of Psychiatry, University of Oulu, Oulu, Finland
    3Department of Forensic Medicine, University of Oulu, Oulu, Finland

    ↵*Corresponding author. Tel: +358 400892330, Fax: +358 8315 5599, Email: heikki.huikuri@oulu.fi

    Received February 22, 2011.
    Revision received May 19, 2011.
    Accepted August 24, 2011.

Abstract

Aims Psychotropic medication increases cardiac mortality, but the reasons for this association are not clear. We studied the role of psychotropic drugs as a triggering factor of sudden cardiac death (SCD) during an acute coronary event.

Methods and results The use of medication was compared between victims of SCD and survivors of an acute coronary event in a case–control study including a consecutive series of victims of SCD (n= 1814, mean age 65 ± 11 years) verified to be due to an acute coronary event at medico-legal autopsy and consecutive series of patients surviving an acute myocardial infarction (AMI; n= 1171, mean age 66 ± 12 years). The medication history was obtained from autopsy/hospital records and interviews with relatives of SCD victims and AMI patients. The use of antipsychotics [9.7 vs. 2.4%, odds ratio (OR) 4.4, 95% confidence interval (CI) 2.9–6.6; P< 0.001] and antidepressants (8.6 vs. 5.5%, OR: 1.6, 95% CI: 1.2–2.2; P= 0.003) was more common in the SCD than AMI group, but the use of benzodiazepines did not differ between the groups (11.7 vs. 13.2%; P= 0.270). The use of antipsychotics remained as a significant risk factor for SCD after adjustment for confounding variables (OR: 3.4, 95% CI: 1.8–6.5; P< 0.001). Combined use of phenothiazines and any antidepressant was associated with a very high risk of SCD (OR: 18.3, 95% CI: 2.5–135.3; P< 0.001).

Conclusion The use of psychotropic drugs, especially combined use of antipsychotic and antidepressant drugs, is strongly associated with an increased risk of SCD at the time of an acute coronary event.