Antipsychotic Drugs and Sudden Death

Sudden, unexpected death may occur in apparently healthy individuals. Its occurrence in psychiatric patients has raised the concern that the use of psychotropics, especially antipsychotics, may be associated with an increased risk of sudden death. This concern is maintained even though not all psychiatric patients who have succumbed to sudden death have been on psychotropics. Early reports presented the concern that the use of chlorpromazine and thioridazine were associated with sudden death. More recently, the focus shifted to the more potent agents. Indeed, the FDA Advisory Committee discussed the possibility of a connection between sudden death and haloperidol. No decision could be reached by the FDA Committee because of the enormous complexity of the problem. Nonetheless, since sudden death continues to catastrophically complicate the course of some patients, the scope of this review is to further investigate the relationship between antipsychotic agents and sudden death

Pharmacotherapy of schizophrenia

Traditionally, schizophrenia was considered to be a severe psychiatric with a chronic course and an unfavorable outcome. Throughout history, there has been incidence of schizophrenia, roughly one percent of the population, consistently, in every culture. It is generally acknowledged that multifactorial etiology, with multiple susceptibility genes interacting with environmental insults to yield a range of phenotypes in the schizophrenia spectrum. The discovery of antipsychotics In the 1950s revolutionized the treatment of schizophrenia and focused on the positive symptoms. By the 1960s however, it became evident that the reduction in positive symptoms did not lead to recovery from schizophrenia and did not significantly improve the outcome. The advent of the novel antipsychotics during the last 15 years represents a significant improvement over the effectiveness of antipsychotics. These agents are, however, not a magic bullet and bear side effects, such as weight gain, diabetes, hyperprolactinemia, and QTc prolongation. Nevertheless, at this point, they seem to be more effective than the conventional antipsychotics. Moreover, advances in the treatment of schizophrenia have been and continue to be urgently needed