In the first half of 2008,4 Charleston WV-area veterans were found dead in their sleep. They were wide awake when when they retired. Each was said to have PTSD and was on Seroquel, an antipsychotic, Paxil, an SSRI antidepressant, and Klonopin, a Valium-like benzodiazepine. Antipsychotics, such as Seroquel and Risperdal—those most widely used in the military–are known to prolong the QT interval (as measured on an electrocardiogram) leading to lethal arrhythmias and sudden cardiac death. I have learned that Seroquel, never approved by the FDA for the treatment of PTSD or as a sleeping aid, is, nonetheless, widely used throughout the military as a ‘sleeping aid.’ It may, in fact be the military’s ‘sleeping aid’ of choice. US Central Command policy allows troops a 90 or a 180 day supply of psychotropic drugs before they deploy and endorses Seroquel as a ‘sleep aid’ in doses of 25 or 50 mg. A June, 2010 report from Department of Defense Pharmecoeconomic Center showed 213,972 or 20% of the 1.1 million active duty troops surveyed were on one or more psychiatric drugs. I have heard a credible estimate that as many as 90 percent of all soldiers are on one or more psychiatric drugs. From 2000 to 2010, the Department of Veterans Affairs spent $717 million for the antipsychotic risperidone (Risperdal) alone. In fiscal year 2007 the VA spent $89 million for 467,217 risperidone prescriptions and $92 million for 740,317 Seroquel prescriptions. Is Seroquel part of that 90 or 180 day supply given to all soldiers as they deploy? Googling ‘dead in bed,’ ‘…in barracks,’ ‘collapses and dies’ ‘collapses and dies after run,’ ‘…after drill,’ we have found, to date, 247 probable sudden cardiac deaths and 63 possible sudden cardiac deaths (SCD). We have given names and such details as have allowed these conclusions to the Surgeon General of the Army, Eric B. Schoomaker, and to the House and Senate Armed Services Committees, and Veterans Affairs Committees. A paper by Krystal et al, in the August 2, 2011 Journal of the American Medical Association concluded: “treatment with risperidone compared to placebo did not reduce symptoms.” Laura Woodin, a spokeswoman for the U.S. division of London-based AstraZeneca, which makes Seroquel, said the drug is not approved by the FDA as a sleep aid or to treat post-traumatic stress disorder. The status of sudden cardiac death in the military will be discussed.
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