Parc Sanitari Sant Joan de Deu Barcelona, Spain
Title: Antipsychotics as a risk factor of venous thromboembolism: The great unknown
o Javier Marchena Yglesias had completed his studies at the School of Medicine, Universidad de Barcelona in 1997 and now he is doing his Ph.D studies at Universidad Autónoma de Madrid. He has published more than 50 papers in reputed journals relationships with venous thromboembolism disease and participated in several trials with new oral anticoagulants. He is an active member of RIETE Registry (Registro informatizado de la Enfermedad Tromboembólica) within numerous conferences.
Antipsychotics as a cause of venous thromboembolism (VTE) are known since 1950 when chlorpromazine reported the first cases. It is an infrequently risk factor of venous thromboembolism despite of the frequently use of this drugs. The risk is between 1.5-5 times among consumer’s vs non consumers. Th e evidence to date on the relationship is based in little observational and case-controls studies. Th e higher risk is associated with first-generation low potency antipsychotic agents, clozapine and olanzapine, the amount of drugs intake by the patients and the doses and immobilization due to sedation or other reason. Th e initiation of treatment is the period with more risk. Potential etiopathogenetic factors leading to VTE include obesity, elevation of antiphospholipid antibodies, increased platelet activation and aggregation mediated by hyperprolactinemia and hyperhomocysteinemia by low folate levels in psychotic patients. Schizophrenia and/or bipolar affective disorder, as well as hospitalization or stress with sympathetic activation and elevation of catecholamine levels, have been reported as known prothrombogenic agents. Th ese patients don’t need any special thromboprophylaxis or treatment with anticoagulants if presented VTE, but is it recommended to switch to lower potency one. Th rombophilia screening it couldn’t do routinely.
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