Antipsychotic medication and venous thrombosis

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Abstract
Background: In an autopsy series, 10 out of 27 deaths in which ‘idiopathic’ pulmonary emboli were discerned as the sole cause of death had occurred in psychiatric patients.Aims: To investigate whether antipsychotic medication is a risk factor for venous thrombosis.Method: A description of the 10 psychiatric patients was obtained from the pulmonary emboli autopsy reports. We carried out a brief historic overview of the literature. We re-analysed data from the Leiden Thrombophilia Study (LETS), a case–control study on patients with venous thrombosis.Results: In the autopsy reports, five out of 10 psychiatric patients with fatal pulmonary embolism had confirmed use of antipsychotic drugs. After the application of chlorpromazine and its analogues a higher incidence of venous thrombosis in psychiatric patients was described in the German literature between 1953 and 1977. In the re-analysis of the LETS case–control study, four patients used antipsychotic drugs versus none in the control group. Recent epidemiological studies of good methodological quality have confirmed these findings.Conclusions: Venous thrombosis appears to be associated with the use of antipsychotic drugs in psychiatric patients.