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Venous Thromboembolism During Treatment with Antipsychotics: A Review of Current Evidence
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Natl Board Forens Med, Dept Forens Genet and Forens Chem, Linkoping, Sweden.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Jönköping, Sweden.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Psychiatry. Region Jönköping, Sweden.
St Olavs Univ Hosp, Norway; Norwegian Univ Sci and Technol, Norway.
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2018 (English)In: CNS Drugs, ISSN 1172-7047, E-ISSN 1179-1934, Vol. 32, no 1, p. 47-64Article, review/survey (Refereed) Published
Abstract [en]

This article summarises the current evidence on the risk of venous thromboembolism (VTE) with the use of antipsychotics. An increasing number of observational studies indicate an elevated risk of VTE in antipsychotic drug users. Although the use of certain antipsychotics has been associated with VTE, current data can neither conclusively verify differences in occurrence rates of VTE between first- and second-generation antipsychotics or between individual compounds, nor identify which antipsychotic drugs have the lowest risk of VTE. The biological mechanisms involved in the pathogenesis of this adverse drug reaction are still to be clarified but hypotheses such as drug-induced sedation, obesity, increased levels of antiphospholipid antibodies, enhanced platelet aggregation, hyperhomocysteinaemia and hyperprolactinaemia have been suggested. Risk factors associated with the underlying psychiatric disorder may at least partly explain the increased risk. Physicians should be aware of this potentially serious and even sometimes fatal adverse drug reaction and should consider discontinuing or switching the antipsychotic treatment in patients experiencing a VTE. Even though supporting evidence is limited, prophylactic antithrombotic treatment should be considered in risk situations for VTE.

Place, publisher, year, edition, pages
ADIS INT LTD , 2018. Vol. 32, no 1, p. 47-64
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Neurology
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URN: urn:nbn:se:liu:diva-147189DOI: 10.1007/s40263-018-0495-7ISI: 000427114400004PubMedID: 29423659OAI: oai:DiVA.org:liu-147189DiVA, id: diva2:1199428
Available from: 2018-04-20 Created: 2018-04-20 Last updated: 2019-04-12

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Jönsson, Anna KSchill, JohanOlsson, HansHägg, Staffan
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Division of Drug ResearchFaculty of Medicine and Health SciencesDepartment of Clinical PharmacologyDepartment of Medical and Health SciencesDepartment of Psychiatry
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