[Adults with intellectual disability : actual concepts and clinical challenges].

The condition of the adult with intellectual disability (AWID) includes the largely autonomous, integrated person but also the one in need of constant support, with grossly altered communication abilities, frequently affected by somatic and mental comorbidities and non-adapted behaviors. Their prevalence is about 1 % of the adult population. They should benefit from particular attention of health care professionals, including in mental health.

Fluoxetine blocks Nav1.5 channels via a mechanism similar to that of class 1 antiarrhythmics.

The voltage-gated Nav1.5 channel is essential for the propagation of action potentials in the heart. Malfunctions of this channel are known to cause hereditary diseases.

Sudden death of cardiac origin and psychotropic drugs.

Mortality rate is high in psychiatric patients versus general population. An important cause of this increased mortality is sudden cardiac death (SCD) as a major side-effect of psychotropic drugs. These SCDs generally result from arrhythmias occurring when the posology is high and may attain a toxic threshold but also at dosages within therapeutic range, in the presence of risk factors.

Hidden cardiac lesions and psychotropic drugs as a possible cause of sudden death in psychiatric patients: a report of 14 cases and review of the literature.

Objective: To confirm the hypothesis that psychotropic drugs, especially neuroleptics, lithium, and antidepressants, are implicated as a cause of unexpected sudden death in psychiatric patients because of their cardiotoxicity, especially when hidden cardiac lesions are present.

Method: We performed a full pathological examination of 14 psychiatric patients who unexpectedly and suddenly died between 1980 and 1999.

Results: Neuroleptics were involved in 13 instances, antidepressants in 9, and anxiolytics in 5.