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PRACTICE: Vinod H Srihari and T Warren Lee Pulmonary embolism in a patient taking clozapine BMJ 2008; 336: 1499-1501 [Full text]

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Joined up atypical thinking

Eugene G Breen   (18 July 2008)

Joined up atypical thinking 18 July 2008
Eugene G Breen, Consultant psychiatrist Adult Psychiatry,Mater Misericordiae Hospital,62/63/Eccles St., Dublin 7, Ireland Send response to journal: Re: Joined up atypical thinking	The article by Srihari and Lee is a great example of real time decision making in difficult situations. Their comprehensive literature trall on emboli and clozapine, and then with atypicals and typicals yielded a workable algorithm to decision making. I would broaden the thinking and generalise to atypicals and thromboembolic/genic phenomena throughout the cardiovascular system. The relatively recent black box warning for atypicals in erlderly demented patients due to accelerated risk of death begs the question whether this is also thrombogenic in aetiology. Should anyone taking antipsychotic medication have safety features built in for example should they take salicylate/warfarin/other ? Competing interests: None declared