You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.


Antipsychotics Linked to Sudden Cardiac Death

  • Authors: News Author: Laurie Barclay, MD
    CME Author:
    Désirée Lie, MD, MSEd
  • CME Released: 6/29/2004
  • Valid for credit through: 6/29/2005, 11:59 PM EST
Start Activity

Target Audience and Goal Statement

This article is intended for primary care physicians, psychiatrists, cardiologists, and other specialists who care for patients using antipsychotic medications.

The goal of this activity is to provide the latest medical news to physicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  • Describe the risk factors for sudden cardiac death and the mechanism associated with sudden cardiac death in those who use antipsychotics.
  • Assess the risk of sudden death in users of antipsychotic medication.


As an organization accredited by the ACCME, Medscape requires authors and editors to disclose any significant financial relationship during the past 12 months with the manufacturer of any product that may relate to the subject matter of the educational activity, whether or not the activity is commercially supported. Authors are also asked to disclose any mention of investigational products or unapproved uses of products regulated by the U.S. Food and Drug Administration.


  • Laurie Barclay, MD

    Laurie Barclay is a freelance reviewer and writer for Medscape.


    Disclosure: Dr. Barclay has reported no significant financial interests.


  • Gary Vogin, MD

    Senior Medical Editor, Medscape


    Disclosure: Gary Vogin, MD, has disclosed no relevant financial relationships.

  • Désirée Lie, MD, MSEd

    Clinical Professor of Family Medicine; Director, Division of Faculty Development, University of California, Irvine School of Medicine, Irvine, California


    Disclosure: Dr. Lie has reported no significant financial interests.

Accreditation Statements

    For Physicians

  • Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Medscape designates this educational activity for 0.25 category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that reflect the time he/she actually spent in the activity.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. Medscape encourages you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 5 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.


Antipsychotics Linked to Sudden Cardiac Death

Authors: News Author: Laurie Barclay, MD CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures

CME Released: 6/29/2004

Valid for credit through: 6/29/2005, 11:59 PM EST


June 29, 2004 — Current use of antipsychotics is associated with an increased risk of sudden cardiac death, according to the results of a population-based study published in the June 28 issue of the Archives of Internal Medicine.

"Antipsychotics have been associated with prolongation of the corrected QT interval and sudden cardiac death," write Sabine M.J. M. Straus, MD, from Erasmus Medial Center in Rotterdam, the Netherlands, and colleagues. "Only a few epidemiological studies have investigated this association."

The case-control study used the Integrated Primary Care Information (IPCI) project, a longitudinal observational database with complete medical records from 150 general practitioners, to identify all deaths between January 1, 1995, and April 1, 2001. Cases of sudden cardiac death were classified by time between onset of cardiovascular symptoms and death, and matched with up to 10 random controls based on age, sex, date of sudden death, and practice. Exposure to antipsychotic medications at the index date was categorized as current use, past use, or nonuse.

Of 554 cases of sudden cardiac death, 334 cases were witnessed. Current use of antipsychotics was associated with a threefold increase in risk of sudden cardiac death. The association with current antipsychotic use was higher for witnessed than for unwitnessed cases. Other factors associated with further increases in the risk of sudden cardiac death were use of butyrophenone antipsychotics, defined daily dose equivalent (DDD) greater than 0.5, and use of antipsychotics for less than 90 days.

Study limitations include possible misclassification of outcome, cardiac death, or antipsychotic exposure and lack of power to compare individual antipsychotic agents.

"Current use of antipsychotics in a general population is associated with an increased risk of sudden cardiac death, even at low dose and for indications other than schizophrenia," the authors write. "Risk of sudden cardiac death was highest among recent users but remained elevated during long-term use."

One of the authors is associated with the IPCI database, which is supported by GlaxoSmithKline, AstraZeneca, Merck, Pharmacia, Sanofi, Pfizer, Schering, Bristol-Myers-Squibb, Eli Lilly, Wyeth, and Yamanouchi.

Arch Intern Med. 2004;164:1293-1297

  • Print