{"id":4442,"date":"2014-03-04T17:47:00","date_gmt":"2014-03-04T14:47:00","guid":{"rendered":"http:\/\/seragpsych.com\/wordpress\/?p=4442"},"modified":"2014-03-04T17:47:00","modified_gmt":"2014-03-04T14:47:00","slug":"sudden-death-in-psychiatric-patients","status":"publish","type":"post","link":"https:\/\/seragpsych.com\/wordpress\/sudden-death-in-psychiatric-patients\/","title":{"rendered":"Sudden death in psychiatric patients"},"content":{"rendered":"
\n

Introduction<\/h1>\n<\/div>\n
\n

Studies using death certificates have indicated an excess of sudden cardiac deaths among users of antipsychotic drugs compared to the general population, but may have underestimated the presence of other known causes of sudden and unexpected death.<\/p>\n

Objectives<\/h4>\n

To assess the cause and risk factors for sudden death discovered by contemporaneous investigation of all deaths occurring over a 26-year period (1984\u20132009) in adult patients registered for care in one large psychiatric hospital in New York.<\/p>\n

Methods<\/h4>\n

Circumstances of death, psychiatric diagnoses, psychotropic drugs and past medical history were extracted from the root cause analyses of sudden\u00a0unexpected\u00a0deaths. After the exclusion of suicides, homicides and drug overdoses, explained and unexplained cases were compared regarding clinical variables and the utilization of antipsychotics.<\/p>\n

Results<\/h4>\n

One hundred cases of sudden death were identified among of 119, 500 patient-years. The death remained unexplained in 52 cases. The incidence of unexplained sudden death was 125\/100,000 (95% CI 88.9\u2013175.1\/100,000) patient-years in 2005\u20132009, 53\/100,000 (95% CI 31.7\u201388.5\/100,000) patient-years in 1999\u20132004 and 7\/100,000 (95% CI 3.7\u201319.4\/100,000) patient-years in 1984\u20131998. Explained and unexplained cases were similar regarding psychiatric diagnoses and treatment with any psychotropic class, including first- and second-generation antipsychotics. Dyslipidemia (p\u00a0=\u00a00.012), diabetes (p\u00a0=\u00a00.055) and co-morbid dyslipidemia and diabetes (p\u00a0=\u00a00.008) were more common in the unexplained than in the explained cases.<\/p>\n

Conclusions<\/h4>\n

In a consecutive cohort of psychiatric patients, the unexplained sudden deaths were associated with known risk factors for coronary artery disease, but not with higher utilization of first- or second-generation anti-psychotics.<\/p>\n

 <\/p>\n

*********************************************************<\/p>\n

Psychiatric patients are at greater risk of sudden death,
\nwith a 3\u20135 fold increase compared with the nonpsychiatric
\npopulation. Sudden death may arise from complications of
\nthe mental illnesses or as a result of psychotropic
\nmedication. Anorexia nervosa, drug use, alcohol misuse
\nare the mental disorders most likely associated with
\nsudden death. A variety of psychotropic drugs,
\nparticularly antipsychotic agents and tricyclic
\nantidepressants are associated with sudden death.
\nInducing cardiac arrhythmias are one of the most likely
\nmechanisms of sudden death because of electric
\nmembrane alterations induced by psychotropic drugs,<\/p>\n

resulting in electrocardiogram changes. Psychotropic
\nmedication is not necessarily causative for excess
\nmortality in psychiatric patients as higher doses might be
\nlinked with mortality through a contradictory factor such
\nas worse physical condition in people with more serious
\nmental health problems. Compared with non-suicide
\nmortality, the number of deaths that might be attributable
\nto medication is small, but according to most researchers,
\niatrogenic mortality must be taken seriously, with
\nappropriate steps taken towards prevention.
\nKey words: unexpected death; mental illnesses; QT
\ninterval prolongation.<\/p>\n

 <\/p>\n

 <\/p>\n

****************************************************************<\/p>\n

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 <\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Introduction Studies using death certificates have indicated an excess of sudden cardiac deaths among users of antipsychotic drugs compared to the general population, but may have underestimated the presence of other known causes of sudden and unexpected death. Objectives To assess the cause and risk factors for sudden death discovered by contemporaneous investigation of all […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,458],"tags":[461,463,161,462],"class_list":["post-4442","post","type-post","status-publish","format-standard","hentry","category-6","category-458","tag-death","tag-hospital","tag-psychiatric","tag-sudden","entry"],"_links":{"self":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/4442","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/comments?post=4442"}],"version-history":[{"count":1,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/4442\/revisions"}],"predecessor-version":[{"id":4443,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/4442\/revisions\/4443"}],"wp:attachment":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/media?parent=4442"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/categories?post=4442"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/tags?post=4442"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}