Do atypical antipsychotics increase the risk of sudden cardiac death similar to typical antipsychotics?
Background For years, there has been concern regarding an association between antipsychotic medications and a negative impact on mortality. In 2001, a retrospective cohort study of 281,744 Tennessee Medicaid enrollees, covering 1,282,996 person-years of follow-up, revealed moderate doses of typical antipsychotics (>100 mg thioridazine equivalents) result in an increased risk of sudden cardiac death.1,2 In the study, 1487 sudden cardiac deaths were reported, and moderate dose users of typical antipsychotics had a significant 2.4-fold increase in the rate of sudden cardiac death as compared to nonusers. In 2005, a meta-analysis of 15 randomized, placebo-controlled trials of atypical antipsychotics in dementia found an increased risk of death in general, not sudden cardiac death in particular, with atypical antipsychotic use as compared to placebo.3 That same year, the Food and Drug Administration (FDA) issued a “talk paper” alerting health care professionals to this higher death rate amo
