ArticleJournal of clinical & experimental cardiology2013
Antipsychotics and the Risks of Sudden Cardiac Death and All-Cause Death: Cohort Studies in Medicaid and Dually-Eligible Medicaid-Medicare Beneficiaries of Five States.
Article in Journal of clinical & experimental cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Algorithms used to identify ventricular arrhythmias and sudden cardiac death in retrospective studies: a systematic literature review.Therapeutic advances in cardiovascular disease · 2018Pooled it
- Repurposing Antipsychotic Agents in Oncology: Mechanistic Rationale, Emerging Evidence, and Therapeutic Potential.Cancers · 2026Review
- Risk factors for sudden cardiac death or sudden unexplained death in patients treated with clozapine: systematic review.BJPsych open · 2026Review
- Comparative cardiac safety of haloperidol vs. chlorpromazine among people receiving hemodialysis.Journal of psychiatric research · 2025Article
- QT Interval, Antipsychotics and Correlates Among Patients with Schizophrenia: Cross-Sectional Data from the Multicentric Real-World FACE-SZ.Drug safety · 2025Article
- Antipsychotic use among older patients with dementia receiving home health care services: Prevalence, predictors, and outcomes.Journal of the American Geriatrics Society · 2023Article
- Haloperidol-induced sudden cardiac arrest in a recently detected HIV and hepatitis C patient: A unique case report.SAGE open medical case reports · 2023Article
- Drug-induced Sudden Death: A Scoping Review.Current drug safety · 2023Article
- Using Medicare Data to Assess the Proarrhythmic Risk of Non-Cardiac Treatment Drugs that Prolong the QT Interval in Older Adults: An Observational Cohort Study.Drugs - real world outcomes · 2021Article
- Drug use and torsades de pointes cardiac arrhythmias in Sweden: a nationwide register-based cohort study.BMJ open · 2020Article
- Causes of death in Prader-Willi syndrome: lessons from 11 years' experience of a national reference center.Orphanet journal of rare diseases · 2019Observational
- Coprescription of QT interval-prolonging antipsychotics with potentially interacting medications in Thailand.Therapeutic advances in drug safety · 2019Article
- Effects of atypical antipsychotic drugs on QT interval in patients with mental disorders.Annals of translational medicine · 2018Article
- Stimulants Do Not Increase the Risk of Seizure-Related Hospitalizations in Children with Epilepsy.Journal of child and adolescent psychopharmacology · 2018Article
- Space-Time Cluster Analysis to Detect Innovative Clinical Practices: A Case Study of Aripiprazole in the Department of Veterans Affairs.Health services research · 2018Article
- Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association.Circulation · 2017Review
- Antidepressants and antipsychotics classified with torsades de pointes arrhythmia risk and mortality in older adults - a Swedish nationwide study.British journal of clinical pharmacology · 2016Article
- Ventricular repolarization measures for arrhythmic risk stratification.World journal of cardiology · 2016Review
- Drug-induced Inhibition and Trafficking Disruption of ion Channels: Pathogenesis of QT Abnormalities and Drug-induced Fatal Arrhythmias.Current cardiology reviews · 2016Review
- Evaluation of the Safety of Quetiapine in Treating Delirium in Critically Ill Children: A Retrospective Review.Journal of child and adolescent psychopharmacology · 2015Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
contextAntipsychotic drugs have been linked to QT-interval prolongation, a presumed marker of cardiac risk, and torsade de pointes.
objectiveTo examine the associations between antipsychotics and 1) outpatient-originated sudden cardiac death and ventricular arrhythmia (SD/VA) and 2) all-cause death.
designTwo retrospective cohort studies.
settingMedicaid programs of California, Florida, New York, Ohio and Pennsylvania. PATIENTS: Incident antipsychotic users aged 30-75 years.
main outcome measures1) Incident, first-listed emergency department or principal inpatient SD/VA diagnoses; and 2) death reported in the Social Security Administration Death Master File.
resultsAmong 459,614 incident antipsychotic users, the incidences of SD/VA and death were 3.4 and 35.1 per 1,000 person-years, respectively. Compared to olanzapine as the referent, adjusted hazard ratios (HRs) for SD/VA were 2.06 (95% CI, 1.20-3.53) for chlorpromazine, 1.72 (1.28-2.31) for haloperidol, and 0.73 (0.57-0.93) for quetiapine. Adjusted HRs for perphenazine and risperidone were consistent with unity. In a subanalysis limited to first prescription exposures, HRs for chlorpromazine and haloperidol were further elevated (2.54 [1.07-5.99] and 2.68 [1.59-4.53], respectively), with the latter exhibiting a dose-response relationship. Results for death were similar.
conclusionsHaloperidol and chlorpromazine had less favorable cardiac safety profiles than olanzapine. Among atypical agents, risperidone had a similar cardiac safety profile to olanzapine, whereas quetiapine was associated with 30% and 20% lower risks of SD/VA and death, respectively, compared to olanzapine. These measured risks do not correlate well with average QT prolongation, further supporting the notion that average QT prolongation may be a poor surrogate of antipsychotic arrhythmogenicity.
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