There have been periodic case reports of sudden death due to aspiration or asphyxiation in patients receiving phenothiazines. The mechanism of death is unknown. The author reports a case of a drug-induced bulbar palsy-like syndrome in a man receiving fluphenazine enanthate and reviews the literature on sudden respiratory death and phenothiazines. He postulates that phenothiazine-induced bulbar palsy may cause laryngeal and/or pharyngeal dysfunctions that are responsible for aspiration.