Sudden death, neuroleptics and psychotic agitation

1. 1. The concept of "neuroleptic death" as a phenomenologically valid entity is still in controversy. The present paper describes 13 cases of sudden, unexpected and unexplained deaths among psychiatric inpatients that might be attribute to neuroleptic treatment. 2. 2. This number represents 7% of the death in three regional psychiatric institutions, during the last decade. All of them manifest a uniform clinical profile: young schizophrenic patients, healthy otherwise, whose post mortem examination failed to reveal the cause of death. Shortly prior to death, all of them suffered from a state of extreme psychotic agitation which did not respond to high dose regime of neuroleptic drugs. 3. 3. The authors suggest that this, common clinical pattern, typical of those patients, which ends by sudden death, is due to sudden neuroleptic death. The authors recommend that in cases of treating resistant pychotic exacerbation, one should seriously consider the risk when increasing doses of neuroleptics or using unusual combinations of these drugs.