Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-07-01T00:14:29.831Z Has data issue: false hasContentIssue false
  • English
  • Français

Association between antipsychotic medication and venous thromboembolism

Published online by Cambridge University Press:  13 June 2014

Santhana Gunasekaran
Santhana Gunasekaran*
Affiliation:
Newton Lodge Regional Secure Unit, Fieldhead Hospital, Wakefield WF1 3SP, England
*
*Correspondence E-mail: san.gunasekaran@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: This study aims to identify and review available evidence in the literature to determine the strength of association between antipsychotic medications and thromboembolism as an adverse effect.

Method: Electronic databases were searched for evidence.

Results: A total of 15 case reports, 14 case series, two observational studies and three case-control studies were found in the literature. Two case control studies found significantly increased risk of venous thromboembolism (OR 13.3 and 7.1 respectively). The risk was high for low potency antipsychotics. Studies were critically appraised to determine the strength of evidence.

Conclusion: The studies reviewed indicate a significant association between antipsychotics and venous thromboembolism. Patients using the antipsychotics and those who prescribe them should be aware of this association.

Keywords

Venous thromboembolismAntipsychoticAdverse effect
Type
Reviews
Information
Irish Journal of Psychological Medicine , Volume 27 , Issue 1 , March 2010 , pp. 22 - 26
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Goldhaber, SZ, Visani, L, De Rosa, M. Acute pulmonary embolism: Clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). The Lancet 1999; 353: 1386–1390.CrossRefGoogle ScholarPubMed
2.Thomassen, R, Vandenbroucke, JP, Rosendaal, F. R. Antipsychotic medication and venous thrombosis. Br J Psychiat 2001; 179: 63–66.CrossRefGoogle ScholarPubMed
3.Brehmer, G, Ruckdeschel, KT. Zur Technik der Winterschlafbehandlung. Deutsche Medizinische Wochenschrift 1953; 78: 1724–1725.CrossRefGoogle Scholar
4.Labhardt, E, Technik, . Nebenerscheinungen und Komplikationen der Largactil Therapie. Schweizer Archives Neurologie und Psychiatrie 1954; 73: 338–344.Google Scholar
5.Grahmann, H, Suchenwirth, R. Thrombosis hazard in chlorpromazine and reserpine therapy of endogenous psychosis. Nervenarzt 1959; 30: 224–225.Google Scholar
6.Lai, S, Bleiman, M, Brown, BN. (1966) Pulmonary embolism in psychiatric patients. J Am Geriatrics Soc 1966; 14: 1138–1143.Google Scholar
7.Kendel, K, Fodor, S. Pulmonary embolism and symptomatic psychosis. German Medical Monthly 1969; 4: 184–187.Google Scholar
8.Scholz, V. Über thromboembolische Komplicationen unter neuroleptischer Medikation. Nervenartz 1967; 38: 174–177.Google Scholar
9.Ziegler, HK. Lungenembolie aus der sieht des Pathologen. Medizinische Klinik 1977; 72: 1063–1070.Google Scholar
10.Meier-Ewert, K, Baumgart, HH, Friedenberg, P. Thromboembolism complications in neuro- and thymoleptic therapy. Deutsche Medizinische Wochenschrift 1967; 92; 2174–2178.CrossRefGoogle ScholarPubMed
11.Hindersin, P, Siegmund, R, Körting, HJ. Thrombophile diathesen als Hämostasestörungen bei akuten psychosen. Psychiatrie, Neurologie und Medizinsche Psycholgie 1984; 36: 702–709.Google Scholar
12.Thorgood, M, Cowen, P, Mann, J. Fatal myocardial infarction and use of psychotropic drugs in young women. The Lancet 1992; 340: 1067–1068.CrossRefGoogle Scholar
13.Walker, AM, Lanza, LL, Arellano, Fet al.Mortality in current and former users of clozapine. Epidemiology 1997; 8: 671–677.CrossRefGoogle ScholarPubMed
14.Clardy, J. Mortality risk and clozapine. Am J Psychiatry 1995; 152: 651.Google ScholarPubMed
15.Coodin, S, Balleteer, T. Clozapine therapy and pulmonary embolism. Can J Psychiatry 2000; 45: 395.Google ScholarPubMed
16.Parkin, L, Skegg, D, Herbison, Pet al.Psychotropic drugs and fatal pulmonary embolism. Pharmacoepidemiology and Drug Safety 2003; 12: 647–652.CrossRefGoogle ScholarPubMed
18.Zornberg G, L, Jick, H. Antipsychotic drug use and risk of first-time idiopathic venous thromboembolism: a case control study. The Lancet 2000; 356: 1219–23.CrossRefGoogle ScholarPubMed
17.Morioka, H, Nagatomo, I, Yamada, K. Deep venous thrombosis of the leg due to psychiatric stupor. Psychiatry Clin Neurosci 1997; 51: 323–326.CrossRefGoogle ScholarPubMed
19.Walley, T, Montagni, A. The UK General Practice Research Database. The Lancet 1997;350:1097–99.CrossRefGoogle ScholarPubMed
21.Kamijo, Y, Soma, K, Nagai, Tet al.Acute massive pulmonary thromboembolism associated with risperidone and conventional phenothiazines. Circulation J 2003; 67: 46–48.CrossRefGoogle ScholarPubMed
22.Hamanaka, S, Kamijo, Y, Nagai, Tet al.Massive pulmonary thromboembolism demonstrated at necropsy in Japanese psychiatric patients treated with neuroleptics including atypical antipsychotics. Circulation J 2004; 68: 850–852.CrossRefGoogle ScholarPubMed
23.Hagg, S, Spigset, O, Soderstrom, TG. Association of venous thromboembolism and clozapine. The Lancet 2000; 355: 1155–1156.CrossRefGoogle ScholarPubMed
24.Ruh-Bernhardt, D, Finance, F, Rohmer, Fet al.Influence of psychotropic therapy on thrombogenesis and platelet functions, A propos of 4 cases of thromboembolic accidents occurring in patients treated by neuroleptics and antidepressants. Encéphale 1976; 2(3): 239–55.Google Scholar
25.Hagg, S, Tatting, P, Spigset, O. Olanzapine and venous thromboembolism. Int Clin Psychopharmacol 2003; Sep 18(5): 299–300.CrossRefGoogle ScholarPubMed
26.Hafner, H, Brehm, I. Thromboembolic complications in neuroleptic treatment. Comprehensive Psychiatry 1965; 6: 25–34.CrossRefGoogle Scholar
27.Schwartz, M, Rochas, M, Toubi, Eet al.The presence of lupus anticoagulant and anticardiolipin antibodies in patients undergoing long-term neuroleptic treatment. J Psychiatry and Neuroscience 1999; 24(4): 351–352.Google ScholarPubMed
28.Wallaschofski, H, Eigenthaler, M, Kiefer, Met al.Hyperprolactinemia in patients on antipsychotic drugs causes ADP-stimulated platelet activation that might explain the increased risk for venous thromboembolism: Pilot study. J Clin Psychopharmacol 2003; 23: 479–483.CrossRefGoogle ScholarPubMed
29.Mueh, JR, Herbst, KD, Rapaport, SI. Thrombosis in patients with the lupus anticoagulant. Annals Internal Med 1980 Feb; 92(2 Pt 1 ): 156–9.CrossRefGoogle ScholarPubMed
30.Varia, I, Krishnan, RR, Davidson, J. Deep-vein thrombosis with antipsychotic drugs. Psychosomatics 1983; 24: 1097–8.CrossRefGoogle ScholarPubMed
31.Singer, L, Finance, F, Ruh, MD. Pulmonary embolism occurring in one month in three aged women with manic depressive psychosis. Discussion. Etiopathogenic role of psychiatric treatment. Annales Medico-Psychologiques 1975; 1: 256–63. [French]Google Scholar
32.Kelley, RE, Gilman, PB, Kovacs, AG. Cerebral ischemia in the presence of lupus anticoagulant. Arch Neurology 1984; 41: 521–3.CrossRefGoogle ScholarPubMed
33.Roche-Bayard, P, Rossi, R, Mann, JM. Left pulmonary artery thrombosis in chlorpromazine-induced lupus. Chest 1990; 98: 1545.CrossRefGoogle ScholarPubMed
34.Pantel, J, Schroder, J, Eysenbach, Ket al.Two cases of deep vein thrombosis associated with a combined paroxetine and zotepine therapy. Pharmacopsychiatry 1997; 30: 109–11.CrossRefGoogle ScholarPubMed
35.Ducloux, D, Florea, A, Fournier, Vet al.Inferior vena cava thrombosis in a patient with chlorpromazine-induced anticardiolipin antibodies. (Letter) Nephrology Dialysis Transplantation 1999; 14: 1335–61.CrossRefGoogle Scholar
36.Lacika, S, Cooper, JP. Pulmonary embolus possibly associated with clozapine treatment. Can J Psychiatry 1999; 44: 396–7.Google ScholarPubMed
37.Maynes, D. Bilateral pulmonary embolism in a patient on clozapine therapy. Can J Psychiatry 2000; 45: 296–7.Google Scholar
38.Suttmann, I, Dittert, S, Landgraf, R. Clozapine and sudden death. The Lancet 2000; 355: 842–3.CrossRefGoogle ScholarPubMed
39.Ihde-Scholl, T, Rolli, ML, Jefferson, JW. Clozapine and pulmonary embolism. Am J Psychiat 2001; 158: 499–500.CrossRefGoogle Scholar
40.Waage, IM, Gedde-Dahl, A. Pulmonary embolism possibly associated with olanzapine treatment. BMJ 2003; 327: 7428.CrossRefGoogle ScholarPubMed
41.Farah, RE, Makhoul, NM, Farah, REet al.Fatal venous thromboembolism associated with antipsychotic therapy. Annals Pharmacotherapy 2004; 38: 1435–8.CrossRefGoogle ScholarPubMed