ANTIPSYCHOTIC DRUGS AND THE RISK OF SUDDEN CARDIAC DEATH

ANTIPSYCHOTIC DRUGS AND THE RISK OF SUDDEN CARDIAC DEATH

Recent pharmaco epidemiological studies have previously demonstrated that, mortality rate in psychiatric patients is higher than the general population. The group of antipsychotic drugs which is a cornerstone in the treatment of psychotic patients, have been associated with sudden cardiac death (SCD). One potential mechanism underlying this adverse effect is the blockade of cardiac potassium channels. This blockade which is the result of the antipsychotic medication, prolongs the QT interval, increases the risk of ventricular tachyarrhythmia and affects the cardiac rhythm adversely which may ultimately lead to cardiac arrest. These SCDs commonly result from arrhythmias in the presence of risk factors such as gender (women), physiopathological conditions (in cases of pre-existing congenital cardiopathies) and other therapeutics (drug interactions and/or overdose). Beside this, some psychotropic drugs may be a direct cause of cardiac lesions leading to SCD.  Since it has been suggested that major part of sudden deaths in psychiatric patients have a cardiac origin, the aim of this review is to describe the risk of SCD related to use of antipsychotic drugs, potential mechanisms in the occurrence of SCD, patient specific and genetic risk factors and to compare the risk of SCD associated with the use of different agents of antipsychotic drugs.

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  • Merve DEMIRBUGEN, H. Sinan SÜZEN
  • Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology Ankara, TURKEY