Pulmonary Embolism in Psychiatric Patients

Lal, Sean; M, Bleiman; Brown, Gene M.

doi:10.1111/j.1532-5415.1966.tb02866.x

Cited by 8 publications

(5 citation statements)

References 11 publications

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“…In 1963, Mahmodian (1963) observed a three-fold increased risk of thrombosis in the period 1958-1961 in psychiatric and neurological patients compared with the years 1915-1922 (from 6% to 18% in males and 10% to 29% in females). In 1966, Lal et al (1966) reported on consecutive autopsies on 357 psychiatric patients diagnosed mainly with schizophrenia and a chronic brain syndrome over the period 1961-1964. The prevalence of pulmonary embolism found in those autopsies was 10%, which was the same as in all autopsies in the general hospital population (Lal et al , 1966).…”

Section: Resultsmentioning

confidence: 99%

“…In 1966, Lal et al (1966) reported on consecutive autopsies on 357 psychiatric patients diagnosed mainly with schizophrenia and a chronic brain syndrome over the period 1961-1964. The prevalence of pulmonary embolism found in those autopsies was 10%, which was the same as in all autopsies in the general hospital population (Lal et al , 1966). However, the occurrence of pulmonary embolism in the general hospital population is known to be high; so, the comparability with a general hospital population in fact points to a high incidence.…”

Section: Resultsmentioning

confidence: 99%

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Antipsychotic medication and venous thrombosis

Thomassen¹,

Vandenbroucke²,

Rosendaal³

2001

Br J Psychiatry

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Antipsychotic medication and venous thrombosis

Thomassen¹,

Vandenbroucke²,

Rosendaal³

2001

Br J Psychiatry

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“…In the early 1950s, a few years after the discovery of chlorpromazine, some cases of fatal PE during treatment with antipsychotics were reported [ 24 , 25 ]. Thereafter, case reports [ 26 , 27 ], case series [ 5 – 10 , 28 – 30 ] and observational studies [ 31 , 32 ] describing VTE in FGA users were published, suggesting a link between VTE and psychosis; however, these studies were inconclusive as they lacked control groups or did not have detailed information about possible confounders. Thus, the association fell into oblivion until 1997 when it was again reported [ 11 ].…”

Section: Early Studiesmentioning

confidence: 99%

“…In early, uncontrolled, observational studies [ 5 – 10 ], a relatively high incidence of PE among patients with schizophrenia and related disorders was reported but the association was not widely acknowledged. However, in the late 1990s, the association again received attention when an increased mortality rate in PE was reported in current users of clozapine compared with past users in a record linkage study on mortality in clozapine users [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Venous Thromboembolism During Treatment with Antipsychotics: A Review of Current Evidence

et al. 2018

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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.

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“…A completely different explanation might be that psychiatric patients have a higher risk of venous thromboembolism. We found a number of papers on the association between psychosis and venous thrombosis, in particular pulmonary embolism, mostly in the German literature between 1960 and 1980; the explanations were in part related to the state of psychosis, and in part to the therapy with neuroleptic drugs (23)(24)(25)(26)(27). The item disappeared from the literature, however, without clear confirmation nor refutation.…”

Section: Discussionmentioning

confidence: 99%

Factor V Leiden and Fatal Pulmonary Embolism

Vandenbroucke¹,

Bertina²,

Holmes³

et al. 1998

Thromb Haemost

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SummaryTo investigate whether the factor V Leiden mutation increases the risk of fatal pulmonary emboli, we determined the presence of the factor V Leiden mutation in pathology material from two series of autopsies of patients from the Leiden University Hospital, The Netherlands. The first series consisted of consecutive autopsies in which pulmonary emboli were mentioned in the autopsy report; most patients of this series had major underlying disease. The second series consisted of autopsies in patients younger than age 70 in which pulmonary emboli were the sole cause of death and no major acquired risk factor for venous thrombosis was present. Extraction of DNA was done on newly prepared tissue from archival paraffin blocks. In the first series, the presence of factor V Leiden was determined in 44 patients, 1 of whom carried the mutation (2.3 percent; 95% confidence interval 0.06 to 12.0 percent). This prevalence is not different from the general population prevalence in The Netherlands. In the second series, factor V Leiden could be determined in 30 patients of whom 3 carried the mutation (10 percent; 95% confidence interval 2.1 to 26.5 percent), which would lead to a threefold relative risk. A large number of patients with diverse psychiatric diagnoses was present in the second series (eleven). We conclude that in the presence of severe illness, the factor V Leiden mutation plays no additional role in the development of pulmonary emboli. The relative risk of the very rare fatal pulmonary embolus that is the sole cause of death might also be less than the relative risk for deep-vein thrombosis in carriers of the factor V Leiden mutation.

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Pulmonary Embolism in Psychiatric Patients

Cited by 8 publications

References 11 publications

Antipsychotic medication and venous thrombosis

Antipsychotic medication and venous thrombosis

Venous Thromboembolism During Treatment with Antipsychotics: A Review of Current Evidence

Factor V Leiden and Fatal Pulmonary Embolism

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