From the Research
Antipsychotic Medication and Venous Thromboembolism (VTE) Risk
- The association between antipsychotic medication and increased risk for deep vein thrombosis and pulmonary embolism has been reported since the introduction of first-generation antipsychotic drugs in the 1950s 1.
- A systematic literature review found that antipsychotic drugs increase the risk of venous thromboembolic events, with an average reported odds ratio of 3.51 compared to patients not receiving these drugs 1.
- The database identified a total of 438 reported cases of venous thromboembolic events with clozapine, nearly double the next most commonly reported medications risperidone and olanzapine 1.
Risk Factors for Antipsychotic-Related Thromboembolic Events
- The factors that increased risk were use of second-generation antipsychotics, low potency antipsychotics, antipsychotic polytherapy 1.
- Data also suggested a dose-dependent increase in the risk of thrombotic complications 1.
- The risk factors for antipsychotic-related thrombolembolic events include recently started antipsychotic therapy, higher doses of drug, concomitant multiple antipsychotic therapy, intravenous or intramuscular administration of drug, and use of second-generation antipsychotics, particularly clozapine 1, 2.
Specific Antipsychotic Medications and VTE Risk
- A meta-analysis found that use of low-potency antipsychotics is the most important risk factor for VTE, followed by atypical, conventional, and high-potency drugs 3.
- Clozapine has been associated with the highest risk of VTE, with a total of 438 reported cases 1.
- Prochlorperazine and risperidone were also associated with elevated risks of VTE 4.
- The risk of VTE with typical and atypical antipsychotics varies with type of drug and is highest just after starting the drug 4.