Since the 1960s, doctors have noticed cases of people on antipsychotic drugs dropping dead from sudden heart problems. Researchers used a Dutch database to find out whether, indeed, people taking antipsychotic drugs were likely to suffer sudden cardiac death.

What they wanted to know: Does taking antipsychotic drugs make sudden cardiac death more likely?

What they did: The researchers took advantage of the Integrated Primary Care Information project, a long-term database on about 500,000 patients from 150 primary-care doctors in the Netherlands. For 1995 to 2001, they found every case of sudden cardiac death. Sudden cardiac death was defined as dying within an hour of the start of heart problems, or if a person who appeared healthy less than 24 hours before died unexpectedly with no evidence that something besides his heart had killed him (like a stroke or pneumonia). For each case of sudden cardiac death, the researchers randomly took up to 10 other people from the database to use as controls; the controls matched the dead person's age, sex, and doctor. Then, on the date the person died, they looked to see if anyone—the dead person or the 10 controls—was on (or had ever been on) antipsychotic drugs.

What they found: People on antipsychotics were three times as likely to die of sudden cardiac death, and the higher the dose, the higher the risk. The risk was the same whether or not the patient had schizophrenia.

What it means to you: Sudden cardiac death is a pretty nasty side effect.

Caveats: Doctors might have misclassified deaths, and the researchers might have missed some sudden cardiac deaths.

Find out more: Schizophrenia from the American Psychiatric Association: http://www.psych.org/

Information on antipsychotics from the government of Victoria, Australia http://www.betterhealth.vic.gov.au

Read the article: Straus, S.M.J.M., et al. "Antipsychotics and the Risk of Sudden Cardiac Death." Archives of Internal Medicine. June 28, 2004, Vol. 164, pp. 1293–1297.

Article online: http://archinte.ama-assn.org/