Abstract
Objective: Venous thromboembolism (VTE) is a serious multifactorial disorder. Patients with severe mental illness have a higher risk of developing the condition compared to the general population. Methods: We observed 10 cases of VTE in patients with mental illness who were treated with the antipsychotic drug olanzapine. The diagnosis of VTE was made at the University Hospital Hradec Kralove (UH HK) from 2004 to 2013. VTE was objectively determined by imaging techniques (duplex ultrasonography, CT angiography) and laboratory tests (D-dimer). The average age was 46 years. The clinical manifestation of VTE was deep vein thrombosis in nine cases, including one case of simultaneous pulmonary embolism and one case of a concurrent ischemic cerebrovascular accident (iCVA). None of our patients had a history of malignant disease, trauma, or surgery. Results: Apart from antipsychotic medication, all the patients had clinical or laboratory risk factors for VTE. The most frequent clinical risk factors were obesity (n = 7) and smoking (n = 6). The most frequent laboratory risk factors were increased levels of FVIII (n = 4), mild hyperhomocysteinemia (n = 3), and factor V Leiden mutation (n = 2). VTE developed within 3 months after antipsychotic drug initiation in three patients and within 6 months in three patients. Conclusion: Olanzapine can be considered a precipitating factor for VTE formation. When olanzapine is administered, we need to monitor for clinical signs and symptoms of VTE, especially when other risk factors are present.
Highlights
Venous thromboembolism (VTE) is a serious and potentially life-threatening condition
Clinical or laboratory risk factors for VTE development were present in all the patients
FV Leiden mutation was detected in two patients. Both clinical and laboratory risk factors were present in half (n = 5) of the patients
Summary
Venous thromboembolism (VTE) is a serious and potentially life-threatening condition. VTE is associated with high morbidity and mortality. Considerable amounts of money are spent on the treatment of VTE in the developed countries of Europe and North America. VTE affects approximately 1.0–1.8 people per 1,000 annually [1, 2]. The incidence rises exponentially with age, VTE as an Adverse Effect During Treatment With Olanzapine and the risk significantly increases in people over the age of 40 years [3]. Multiple risk factors are involved in the development of VTE. VTE risk factors can be divided into physiological and pathophysiological, clinical and laboratory, and congenital and acquired factors (Table 1) [1, 2, 4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
