Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Thioridazine: Re-evaluating the Risk/Benefit Equation

Thioridazine: Re-evaluating the Risk/Benefit Equation The piperidine phenothiazine thioridazine has been in use for 40 years. As clinical experience has accumulated, scattered reports of sudden death and fatal or nonfatal arrhythmias during routine therapeutic use have been published. This paper reviews the case reports and retrospective studies that have been published to date. Four new case reports in which thioridazine in standard therapeutic doses is implicated as the cause of death or as contributing to the cause of death are presented. The author concludes that the accumulated clinical experience of thioridazine's potential for cardiotoxicity coupled with the availability of alternative, safer antipsychotic medications shifts the risk/benefit equation away from justifying widespread use. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Clinical Psychiatry Springer Journals

Thioridazine: Re-evaluating the Risk/Benefit Equation

Timell, Anna
Annals of Clinical Psychiatry , Volume 12 (3) – Oct 8, 2004
Download PDF
5 pages

Loading next page...
 
/lp/springer-journals/thioridazine-re-evaluating-the-risk-benefit-equation-TAqPO6JUzd
Publisher
Springer Journals
Copyright
Copyright © 2000 by American Academy of Clinical Psychiatrists
Subject
Medicine & Public Health; Neurology; Psychiatry; Psychopharmacology
ISSN
1040-1237
eISSN
1573-3238
DOI
10.1023/A:1009064901907
Publisher site
See Article on Publisher Site

Abstract

The piperidine phenothiazine thioridazine has been in use for 40 years. As clinical experience has accumulated, scattered reports of sudden death and fatal or nonfatal arrhythmias during routine therapeutic use have been published. This paper reviews the case reports and retrospective studies that have been published to date. Four new case reports in which thioridazine in standard therapeutic doses is implicated as the cause of death or as contributing to the cause of death are presented. The author concludes that the accumulated clinical experience of thioridazine's potential for cardiotoxicity coupled with the availability of alternative, safer antipsychotic medications shifts the risk/benefit equation away from justifying widespread use.

Journal

Annals of Clinical Psychiatry – Springer Journals

Published: Oct 8, 2004

References

  • Sudden death during treatment with phenothiazine derivatives
    Hollister, LE; Kosek, JC
  • Human tissue distribution of thioridazine during therapy and after poisoning
    Baselt, RC
  • Distribution of thioridazine and its metabolites in human tissues and fluids obtained postmortem
    Dinovo, EC
  • Therapeutic and toxic drug concentrations in postmortem blood: a six year study in the state of Maryland
    Caplan, YH; Ottinger, WE; Crooks, RC
  • Thioridazine enantiomers in human tissues
    Jortani, SA; Valentour, JC; Poklis, A
  • Postmortem drug redistribution-human cases related to results in experimental animals
    Hilberg, T; Rogde, S; Morland, J
  • Thioridazine hydrochloride: its effect on the electrocardiogram and a report of two fatalities with ECG abnormalities
    Kelly, HG; Fay, JE; Laverty, SG
  • Thioridazine and electrocardiographic abnormalities
    Wendkos, MH
  • Antiarrhythmic activity of thioridazine hydrochloride
    Madan, BR; Pendse, VK
  • The effect of phenothiazines on the electrocardiogram
    Ban, TA; St. Jean, A
  • Electrocardiographic changes associated with the use of thioridazine
    Graupner, KI; Murphree, ED
  • Electrocardiographic changes induced by phenothiazine drugs
    Ban, TA
  • The effect of thioridazine hydrochloride and chlorpromazine on the ECG
    Huston, JR; Bell, GE
  • Electrocardiographic effects of thioridazine hydrochloride
    Alexander, S; Shader, R; Grinspoon, L
  • Cardiotoxic effects of Mellaril: Conduction disturbances and supraventricular arrhythmias
    Fletcher, GF; Kazamias, TM; Wenger, NK
  • Q-T prolongation associated with the use of thioridazine hydrochloride (Mellaril)
    Kalbian, VV
  • The significance of electrocardiographic changes produced by thioridazine
    Wendkos, MH
  • An electrocardiographic survey of thioridazine treated-patients
    Wendkos, MG; Thornton, CC
  • Electrocardiographic changes following intravenous administration of thioridazine to Macaque monkeys
    Moore, RH; Rainey, JM
  • Electrocardiographic changes and serum concentrations in thioridazine-treated patients
    Axelsson, R; Aspenstrom, G
  • Cardiovascular effects of phenothiazines: a review
    Habibzadeh, MA
  • A comparison of the cardiovascular effects of haloperidol, thioridazine and chlorpromazine hydrochloride
    Brannan, MD; Riggs, JJ; Hageman, WE; Pruss, TP
  • Cardiotoxicity of thioridazine and two stereoisomeric forms of thioridazine 5-sulfoxide in the isolated perfused rat heart
    Hale, PW; Poklis, A
  • Transient cardiac pacing is insufficiently used to treat arrhythmia associated with thioridazine
    Donatini, B; Le Blaye, I; Krupp, P
  • Electrocardiographic changes and cardiac arrhythmias is patients receiving psychotropic drugs
    Fowler, NO
  • Effects of thioridazine (Mellaril) on ventricular electrophysiologic properties
    Yoon, MS
  • Factors influencing phenothiazine-induced ECG changes
    Nasrallah, HA
  • Letter to the editor: hypotensive effect of phenothiazines
    Turnbull, J
  • Cardiovascular side-effects of phenothiazines and tricyclic antidepressants
    Lipscomb, PA
  • Drug-induced orthostatic hypotension
    Schoenberger, JA
  • Case report: hypotensive effects of thioridazine in an elderly patient with traumatic brain injury
    Cowen, TD; Meythaler, JM
  • Letter to the editor: acute hypotension from thioridazine
    Kumar, BB
  • Ventricular tachycardia associated with administration of thioridazine hydrochloride: case report
    Desautels, S; Filteau, C; St.-Jean, A
  • Thioridazineinduced ventricular tachycardia controlled with an artificial pacemaker
    Schoonmaker, FS; Osteen, RT; Greenfield, JC
  • Phenothiazine deaths: a critical review
    Peele, R; von Loetzen, I
  • Death associated with ventricular arrhythmia and thioridazine hydrochloride
    Giles, TD; Modlin, RK
  • Sudden unexplained death in a psychiatric patient taking thioridazine
    Goodson, WH; Litkenhous, EE
  • Death attributed to ventricular arrhythmia induced by thioridazine in combination with a single Contac.C capsule
    Chouinard, G; Ghadirian, AM; Jones, BD
  • Sudden death in a patient taking antipsychotic drugs
    Thomas, SHL; Cooper, PN
  • Recurrent major ventricular arrhythmias associated with thioridazine therapy
    Rosenquist, RJ; Brauer, WW; Mork, JN
  • Case report: successful treatment of ventricular tachycardia associated with thioridazine
    Tranum, BL; Murphy, ML
  • Thioridazine-induced torsades de pointes: successful therapy with isoproterenol
    Kemper, AJ; Dunlap, R; Pietro, DA
  • Iatrogenic torsades de pointes induced by thioridazine
    Kiriike, N
  • Ventricular tachycardia associated with desipramine and thioridazine
    Wilens, TE; Stern, TA
  • Thioridazine, diarrhoea and torsades de pointe
    Denvir, MA; Sood, A; Dow, R; Brady, AJ; Rankin, AC
  • Thioridazine-r-sulfoxide cardiotoxicity in the isolated, perfused rat heart
    Hale, PW; Poklis, A
  • Plasma concentrations of thioridazine metabolites and ECG abnormalities
    Gottschalk, LA; Dinovo, E; Biener, R; Nandi, BR
  • Thioridazine-r-sulfoxide and EKG abnormalities
    Dinovo, EC
  • Letter to the editor: thioridazine cardiotoxicity
    Hale, P; Poklis, A
  • Medication use and mortality
    Craig, TJ; Lin, SP
  • A survey of sudden death associated with use of antipsychotic or antidepressant drugs: 49 cases in Finland
    Mehtonen, OP; Aranko, K; Malkonen, L; Vapaatalo, H
  • Cardiotoxicity more common in thioridazine overdose than with other neuroleptics
    Buckley, NA; Whyte, IM; Dawson, AH
  • Are psychotropic drugs at therapeutic levels a concern for cardiologists
    Burggraf, GW
  • Letter to the editor: death attributed to ventricular arrhythmias
    Wendkos, MH