Antipsychotics Linked To Sudden Cardiac Death: Significant Risk Associated with Drug Use

The term “sudden cardiac death” (also called sudden arrest) refers to death that results when the heart stops abruptly (cardiac arrest). Death typically occurs within minutes after symptoms appear. Victims may or may not have a diagnosed heart condition.

About one half of the more than 600,000 people who die each year of coronary heart disease never reach a hospital or emergency room. Most of these people—about 850 Americans per day—die of sudden cardiac death.

Causes of Sudden Cardiac Death

Scientists have long known that any of the known heart diseases can lead to sudden cardiac death. Ninety percent of adults who succumb to sudden cardiac death have blockage in two or more major coronary arteries. Two-thirds of victims have scarring from a previous heart attack.

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In young adults, abnormalities of the heart are more often the cause of sudden cardiac death. It is not uncommon for vigorous physical activity, including among seasoned athletes, to be the trigger for sudden cardiac death among young adults who die of the disease.

Role of Antipsychotics in Sudden Cardiac Death

Scientists have known for some time that use of typical antipsychotics drugs increases a person’s risk of serious ventricular arrhythmias and sudden cardiac death. However, the impact of atypical antipsychotics has not been well studied. This is important since atypical antipsychotic use has largely replaced use of the typical forms.

Researchers examined sixteen years of data from populations of patients who had taken typical antipsychotic drugs, atypical antipsychotic drugs, and placebo. This included more than 90,000 people who were using some form of antipsychotics and more than 180,000 controls. The investigators found that:

  • People who currently used either typical or atypical antipsychotics doubled their risk for sudden death compared with controls
  • The risk for sudden cardiac death increased as the dose increased among current drug users
  • Patients who had formerly used antipsychotics did not have an increased risk for sudden cardiac death when compared to controls

What Patients Can Do

People who are taking antipsychotics should talk to their doctor about the benefits and dangers of continuing their use, and about possible alternative medications or treatments. This suggestion is especially important for the elderly, particularly since antipsychotic use in Alzheimer’s patients has been associated with increased risk of death. Antipsychotic use is also cautioned for children and for people who have known heart disease, risk factors for heart conditions, or a history of heart disease in their family.

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