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Psychosis, depression, and high risk for sudden cardiac death: time for co-operation between psychiatrists and cardiologists

Josep Brugada
DOI: http://dx.doi.org/10.1093/eurheartj/ehr405 687-688 First published online: 31 October 2011

This editorial refers to ‘Psychotropic medications and the risk of sudden cardiac death during an acute coronary event’, by J. Honkola et al., on page 745

Psychiatric patients have an excess rate of unexplained sudden death.1 Some studies have linked this to the disease itself and to an increased prevalence of other risk factors such as dyslipidaemia and diabetes in this population.2 However, a number of observations have suggested that the use of antipsychotic and antidepressant drugs might be at the root of these deaths.

Figure 1

The triangle of sudden death in psychiatric patients.

The work coming from the University of Oulu4 can bring some clarity to this debate. Is this a population at higher risk for sudden cardiac death who should be screened and treated accordingly, or is the treatment they receive the reason for the excess mortality, and thus the drugs administered to them should be carefully selected based on the probability of …