Antipsychotics & Sudden Cardiac Death

February 5th, 2009 | Sources: NEJM, NY Times

Subjects:

Atypical antipsychotic drugs like Risperdal, Zyprexa and Seroquel double the risk of sudden cardiac death according to a study in the New England Journal of Medicine.

iainttakinthatstuff!To reach this conclusion, Wayne Ray and colleagues at Vanderbilt reviewed Medicaid claims data for 276,907 people that were between 30-74 years old and had no cardiac history.

Remarkably, between 1990 and 2005 one third of that population received a prescription for antipsychotics. There were 478 sudden cardiac deaths in this group, twice the rate in controls. That’s 3 deaths per 1,000 people per year for those on the juice.

The increased risk was present in those taking the newer, atypical antipsychotics and those taking the older varieties, and it became more pronounced at higher doses. 

These days, 90% of prescriptions for schizophrenia are for an atypical antipsychotic even though government sponsored studies from 2005 suggest these drugs are not more effective than the older antipsychotics which are available in generic form and cost a tenth as much.

In 2006, scientists found that atypical antipsychotics are not effective for situational psychoses associated with Alzheimer’s disease and other forms of dementia, yet they are widely prescribed for this.

The newer drugs are also commonly used to manage emotional lability complicating psychiatric disorders of childhood such as attention deficit disorder and autism, although they are not FDA-approved for this purpose.

And then there are the side effects which include marked weight gain, metabolic abnormalities and tics. More than 1,200 children have suffered serious problems attributable to Risperdal alone, and 31 of them died.

 “Physicians need to do a careful cardiovascular evaluation prior to prescribing these drugs, especially if there are alternative treatments,” Ray told the Wall Street Journal. And “if they’re used, (use) the lowest possible dose.”


 

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