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The Silent Patient hooks you with one question - why did Alicia Berenson shoot her husband and then never speak again? - and pulls the rug from under you in its final pages. Here our editors pick the psychological thrillers that deliver the same unreliable narrators, the same therapy-room tension and twists you genuinely won't see coming.
The short answer
- Closest match
- Sometimes I Lie by Alice Feeney — the same late rug-pull
- Best by the same author
- The Maidens by Alex Michaelides — a Cambridge murder, with a familiar cameo
- Best twist
- Gone Girl by Gillian Flynn — still the standard
What to look for in a Silent Patient readalike
The hallmarks are a narrator you can't quite trust, a claustrophobic setting, secrets let out a page at a time and a twist that makes you want to start again from page one. Domestic noir and psychological suspense sit side by side below - the common thread is that nothing, and nobody, is quite what it seems.
Our pick of books like The Silent Patient
The Maidens by Alex Michaelides
Michaelides's follow-up: a group therapist becomes convinced a charismatic Cambridge professor is a murderer - with a cameo from Theo Faber.Gone Girl by Gillian Flynn
The marriage thriller that rewrote the rules: a wife vanishes, a husband looks guilty, and nothing is what either of them says.“The book that has taken the world by storm, now a huge film starring Ben Affleck and Rosamund Pike”Our review, by Sarah Broadhurst
Reviewed by Sarah BroadhurstSometimes I Lie by Alice Feeney
Amber is in a coma, unable to move or speak - and warns you from the first page that she sometimes lies.“A novel to meddle with your reasoning and taunt your gut instincts… Amber is in hospital in a coma, her thoughts are knocking at the door of her awareness as she attempts to remember what has happened to her”Our review, by Liz Robinson
Reviewed by Liz RobinsonAudiobook read by Stephanie RacineThe Girl on the Train by Paula Hawkins
An unreliable narrator on a daily commute sees something she shouldn't; tense, twisty and hard to put down.“In the footsteps of Gillian Flynn's Gone Girl and S.J”Our review, by Sarah Broadhurst
Reviewed by Sarah BroadhurstAudiobook read by India Fisher, Clare Corbett and Louise BrealeyBehind Her Eyes by Sarah Pinborough
A love triangle with a secret at its centre, and an ending so audacious readers are still arguing about it.“One of Our Books of the Year 2017 | Oh my word, this book is devious, twisted, and an absolute knockout!”Our review, by Maxim Jakubowski
Reviewed by Maxim JakubowskiAudiobook read by Anna Bentinck, Josie Dunn and Bea HollandThe Woman in the Window by A. J. Finn
A psychologist who cannot leave her house watches her neighbours - and sees a crime nobody believes happened.“Oh my word, this is an absolutely cracking psychological thriller”Our review, by Liz Robinson
Reviewed by Liz RobinsonAudiobook read by Ann Marie LeeBefore I Go to Sleep by S. J. Watson
A woman who loses her memory every night rebuilds her life from a journal, and learns who not to trust.“A stylish, gripping and surprising thriller, which is now a film starring Nicole Kidman and Colin Firth”Our review, by Sarah Broadhurst
Reviewed by Sarah BroadhurstAudiobook read by Susannah HarkerThe Guest List by Lucy Foley
A glamorous wedding on a remote Irish island, a guest list full of grudges, and a body.“A masterful murder mystery set on a remote island with a celebrity wedding taking centre stage… this has star quality stamped all over it”Our review, by Liz Robinson
Reviewed by Liz RobinsonAudiobook read by Jot Davies, Chloe Massey, Sarah Ovens and othersThe Housemaid by Freida McFadden
A live-in maid with a past takes a job with a wealthy family, and finds the house has rules of its own.Audiobook read by Lauryn AllmanThe Wife Between Us by Greer Hendricks and Sarah Pekkanen
What looks like a jealous ex obsessing over her replacement turns into something else entirely.
Who chose these books, and why that matters
This is not a list pulled from a bestseller chart. Every title here was read and chosen by the LoveReading editorial panel, and we turn far more books down than we put forward.
The panel includes a judge of the Crime Writers’ Association Gold Dagger; a past Chair of the CILIP Carnegie and Kate Greenaway Medals; a former children’s editor of the Guardian, who is also Children’s Director of the Hay Festival; a Managing Director of the Hay Festival of twenty years; the founder of the Murder One bookshop, who has reviewed for the Guardian, The Times and the Daily Telegraph; and two UK School Librarians of the Year.
Each is named, with a photograph and full biography, on our editorial experts page.
Members of the panel include:
Liz RobinsonLoveReading reviewer since 2014 and former judge of the CWA Gold Dagger
Maxim JakubowskiCrime writer, editor and critic, and founder of London’s Murder One bookshop
Alison FloodBooks journalist and critic whose work has appeared in the Guardian, Observer and Sunday Times
Victoria GoldmanAuthor, health journalist and editor with more than 25 years’ experience
Their judgements are informed by our Reader Review Panel — several hundred readers across our adult and children’s sites who read titles before publication and tell us plainly whether a book delivers.
LoveReading has been recommending books since 2004 and has reviewed more than 33,000 titles in that time. Every physical book bought through us donates 25% of the cover price to a school of your choice — more than £100,000 in books so far.
Where to start
For more of Alex Michaelides, go straight to The Maidens. For the definitive marriage-and-lies thriller, it has to be Gone Girl; and if it was that final-act reveal you loved most, Sometimes I Lie is the closest match.
Your questions answered
What kind of book is The Silent Patient?
A psychological thriller. A psychotherapist becomes obsessed with treating a famous painter who has not spoken since she was accused of murdering her husband, and the novel is best known for its unreliable narration and its final twist.
Is there a sequel to The Silent Patient?
Not a direct sequel, but Alex Michaelides's second novel, The Maidens, is set in the same world and includes a brief appearance from Theo Faber. His third novel, The Fury, is a standalone.
Are these recommendations generated by an algorithm?
No. They're curated by LoveReading's editors and informed by our 800-strong Reader Review Panel, who read widely across every genre. We've recommended on merit, not sales rank, since 2004.
Which book is most like The Silent Patient?
For the closest match in structure and that last-minute rug-pull, try Sometimes I Lie by Alice Feeney. For more of the same author, read The Maidens.
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- Guest Editor, T.M. Logan's Lean and Mean Thrillers to Binge in a WeekendJuly 2026
- Best Books about Serial Killers — 40+ Novels That Reel with Multiple Murders Most HorridDecember 2023