SUDDEN DEATH OF A CATATONIC PATIENT RECEIVING PHENOTHIAZINE
FRANK P. JOHNSON M.D.1,
DAVID A. BOYD JR. M.D.2,
GEORGE P. SAYRE M.D.3, , and
FRANCIS A. J. TYCE M.D.1
1 Fellow in Psychiatry, Mayo Foundation; Section of Psychiatry
2 Section of Experimental and Anatomic Pathology, Mayo Clinic and Mayo Foundation
3 Medical Director, Rochester State Hospital, Rochester, Minn.
A case of sudden unforeseen death in a young, physically well, acutely catatonic patient has been presented. The findings at necropsy were not sufficient to explain either her death or her psychotic behavior. The terminal period was brief, lasting minutes. Contrastingly, sudden deaths in schizophrenic patients reported in the earlier literature generally were characterized by a terminal period lasting hours or days.
The role of phenothiazines in the death of our patient is uncertain. Nonetheless, one should remain alert to the possibility of massive brain-stem inhibition occurring in patients receiving large doses of phenothiazines.
The character of our patient's death closely simulates sudden death as described by several authors in physically well adults. These deaths were unrelated to medication and were considered as primarily the result of a physiologic or psychophysiologic hyperreactive state.
