Psychiatric Treatment and Sudden Unexpected Death

, Byung Yoon, Lee

Original Article

Korean Journal of Legal Medicine 1984;8(Suppl DB Error: syntax error):57-59.

Department of Neuropsychiatry, Korea University, Medical College

Abstract

Sudden death during psychiatric treatment become much rare since the introduction of effective and patent psychopharmacological agents during the later half of 1950. Occasionally reported sudden death for these days usually associated with suicide of depressed patients and schizoaffective patients. Depressed patients usually thinks about death and suicide so that if the patient's suicidal possibility is strong psychia trist should give suicidal precaution to psychiatric nurses and ward attendants or patient's family if treated as ambulatory basis, so that suicide of depressed patients should be prevented. But most embarassing cases of suicide were schizoaffective ones which usually not anticipated and unexpected. Other sudden death or fatality were related with antipsychotic medication and antidepressants. In the case of sudden death during antipsychotic treatment the mechanism is unknown. But in the case of sudden death during tricyclic antidepressant treatment it is usually associated with heart problem. Tricyclic antidepressants are usually cardiotoxic so that it is mandatory to reserve the use of tricyclic antidepressant to those patients who had history of cardiac disease. Another drug associated sudden death related to monoamine oxidase inhibitors is due to hypertensive crisis. So that during MAOI treatment no medicinal amine agents nor food containing high doses of tyramine must be avoided.