Evaluating the association between clozapine and venous thromboembolism

Abstract

Available data indicate an association between clozapine and VTE; however, it is unknown whether the increased risk of VTE in patients receiving clozapine is because of prothrombotic effects of the drug. Risk of VTE versus the benefits of therapy should be considered when initiating clozapine therapy.

Risk of venous thromboembolism due to antipsychotic drug therapy

“…After the turn of the millennium several further studies [9][10][11][12][13][14][15][16][17][18][19], case series [20][21][22][23] and case reports suggesting an increased risk of VTE in patients using antipsychotics have been published. The association has previously been summarised by us [5] as well as by others [24,33,48,49]. The aim of this article is to critically review the available data on the risk for VTE in users of antipsychotics.…”

“…The link between clozapine and VTE has been investigated in several studies [6,16,18,19] and case series [7,21,22] and in several case reports [5,[24][25][26][27][28][29][30][31][32][33]. In a US record linkage study [6] mortality rates of various causes of death in 67,072 current and former clozapine users was investigated.…”

An update of safety of clinically used atypical antipsychotics

“…Furthermore, several cases of clozapine-related pericarditis have been reported in literature among patients on long-term stable clozapine regimens or during titration phase [96]. In addition, some published data indicate an association between clozapine and venous thromboembolism [97].…”

Agranulocitosis secundaria a clozapina: un estudio descriptivo en pacientes chilenos

“…Cabe mencionar que la plataforma virtual de farmacovigilancia no está diseñada para realizar este tipo de estudios. Además, ésta no cuenta con un registro de las reacciones adversas no hematológicas por lo que no es posible realizar un análisis considerando estos datos, lo cual es de especial relevancia ya que en los estudios publicados en los últimos 10 años se ha puesto especial interés a los efectos adversos de la clozapina; tales como la miocarditis con una incidencia estimada de 1,2% 19 , trombosis venosa profunda 20 , aumento de peso 21,22 , alteraciones en el metabolismo de la glucosa 23 y constipación 24 ; el conocimiento de estas complicaciones ha llevado a ampliar la cantidad de estudios que se realizan en los pacientes que toman este fármaco, con el fin de mejorar su salud y calidad de vida.…”