Psychotropics and sudden cardiac death.

Over the past two decades there has been a large increase in the number of patients prescribed psychotropic medications. Many of these agents are associated with QTc prolongation which is considered a marker for increased risk of sudden cardiac death due to malignant arrhythmias such as Torsades de pointes (TdP). Psychotropics rarely lead to sudden death in healthy individuals on a single QTc prolonging medication. However, factors such polypharmacy, recent initiation of a QTc prolonging medication, bradycardia, electrolyte abnormalities and preexisting arrhythmias increase the likelihood of psychotropic-induced sudden cardiac death. Therefore, clinicians must recognize which psychotropics and risk factors are associated with increased risk in order to minimize the risks of psychotropic QTc prolongation.