Sudden Death and Phenothiazines

Death from Fright: Report of a Case and Literature Review

“…She was successfully resuscitated (4). Leestma and Koenig (13) summarize 26 cases thought to represent phenothiazine deaths; all of these patients received higher dosages than did our patient and often had clinical manifestations not exhibited by our patient (13).…”

Toxicological data on phenothiazine drugs in autopsy cases

“…T o x i c o l o g i c a l d a t a are t r a d i t i o n a l l y p r e s e n t e d in t h e f o r m of [1] a n i m a l e x p e r i m e n t s , [2] The data reported in Tables 4--6 represent the sum of parent drug and non-phenolic metabolites with similar ultraviolet spectra. from such publications is rarely sufficent for evaluating toxic, let alone lethal doses of a given type of drug for the human organism, since such doses are by no means sharply defined but depend on a large number of factors.…”

Investigation of Deaths of Chronically Disabled Persons and Institutionalized Persons

“…Ever since psychotropic (neuroleptic; phenothiazine) drug use was introduced within the psychiatric profession, reports of adverse effects of these drugs have occurred. A variety of untoward effects are associated with these drugs, including hyperthermia, neuroleptic malignant syndrome (muscular rigidity and incoordination, autonomic dysfunction, hyperthermia), respiratory dyskinesia (laryngeal–pharyngeal dystonia), seizures, allergic reactions, including agranulocytosis, and sudden death related to cardiac effects (93, 94), which include cardiac arrhythmias (95) and sudden catastrophic hypotension (93–95), related to anti-adrenergic vasodilation (94). Electrocardiogram alterations have been documented with neuroleptic agents (96), as has catecholamine receptor blockage (97).…”

“…Asphyxia related to aspiration has also been implicated as a potential mechanism of death (95). Anticholinergic properties of phenothiazines may also predispose to ileus and toxic megacolon, leading to sepsis and death (98).…”