PsychRights®
Law Project for
Psychiatric Rights
Neuroleptics and Fatal Blood Clots
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Antipsychotic drugs and risk of
venous thromboembolism: nested case-control study, byChris Parker,
Carol Coupland, and Julia Hippisley-Cox, British Medical Journal,
341:c4245 (2010)
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Fatal
venous thromboembolism associated with antipsychotic therapy, Farah RE,
Makhoul NM, Farah RE, Shai MD., Ann Pharmacother. 2004 Sep;38(9):1435-8.
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Psychotropic drugs and fatal pulmonary embolism, by Parkin L, Skegg DC,
Herbison GP, Paul C., by Pharmacoepidemiol Drug Saf. 2003 Dec;12(8):647-52.
Compared to non-use, the adjusted odds ratio for current use of
antipsychotic drugs was 13.3 (95% CI: 2.3-76.3). Low potency antipsychotics
appeared to carry the highest risk (odds ratio: 20.8 [95% CI: 1.7-259.0]).
The main drug involved was thioridazine. The odds ratio for current use of
antidepressants was also increased, at 4.9 (95% CI: 1.1-22.5).
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Antipsychotic medication and venous thrombosis, by Thomassen R,
Vandenbroucke JP, Rosendaal FR, Br J Psychiatry. 2001 Jul;179:63-6. Venous
thrombosis appears to be associated with the use of antipsychotic drugs in
psychiatric patients.
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Antipsychotic drug use and risk of first-time idiopathic venous
thromboembolism: a case-control study, by Zornberg GL, Jick H, Lancet.
2000 Oct 7;356(9237). This article concluded current exposure
to conventional antipsychotic drugs significantly increases the risk of
idiopathic venous thromboembolism in men and women younger than 60 years of
age. A letter and the author's response are also included.
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Venous thromboembolism among elderly patients treated with atypical and
conventional antipsychotic agents, by Liperoti R, Pedone C, Lapane KL,
Mor V, Bernabei R, Gambassi G., Archives of Internal Medicine, 2005
Dec 12-26;165(22):2677-82. This study concluded atypical antipsychotic
agents appear to increase the risk of Venous thromboembolism among elderly
patients.
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Associations Between Venous Thromboembolism and Antipsychotics : A Study of
the WHO Database of Adverse Drug Reactions, by Hägg S, Bate A, Stahl M,
Spigset O.Drug Saf. 2008;31(8):685-94. This study concluded venous
thromboembolism was more often reported with the antipsychotic drugs
olanzapine, sertindole and zuclopenthixol than with other drugs in the WHO
database.
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Hyperprolactinemia in patients on antipsychotic drugs causes ADP-stimulated
platelet activation that might explain the increased risk for venous
thromboembolism: pilot study, by Wallaschofski H, Eigenthaler M, Kiefer
M, Donné M, Hentschel B, Gertz HJ, Lohmann T., J Clin Psychopharmacol. 2003
Oct;23(5):479-83. Hyperprolactinemia might be the yet unknown acquired risk
factor in patients on antipsychotic drugs explaining the increased risk for
venous thromboembolism in these patients.
Neuroleptics: increased rate of venous
thromboembolic events, Prescrire Int. 2006 Dec;15(86):224. (1) Neuroleptics have
long been implicated in venous thromboembolic effects. (2) A cohort study of
elderly patients showed that users of atypical neuroleptics have twice the
relative risk of hospital admission for thromboembolism (95% confidence interval
1.50-2.70). (3) Results of a case-control study of 42 patients with a history of
venous thromboembolism were similar: the risk of thrombosis increased by a
factor of at least 7 among users of conventional neuroleptics under 60 years of
age. (4) A case-control study of 62 cases of fatal pulmonary embolism showed a
13-fold higher risk among neuroleptic users. (5) It is not possible to compare
the risks associated with conventional and atypical neuroleptics. (6) In
practice, the risk of venous thromboembolism should be taken into account when
deciding whether or not to prescribe a neuroleptic, and it should also be borne
in mind during treatment.
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Last modified 09/22/2010
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