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LETTERS: David Curtis Effect of antipsychotics on stroke risk remains unproved BMJ 2008; 337: a1673 [Full text]

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Antipsychotics and thromboembolism

Eugene G Breen   (24 September 2008)

Antipsychotics and thromboembolism 24 September 2008
Eugene G Breen, Consultant Psychiatrist 62/63 Eccles St , Dublin 7, Ireland Send response to journal: Re: Antipsychotics and thromboembolism	The data base for the association between antipsychotic use and the occurrence of thromboembolism is robustly skewed towards there being an increased incidence. A literature search shows an increased incidence of pulmonary embolism in antipsychotic users of the order of at the minimum 3 fold. It could well be that any medicine that increases sedentary and somnolent lifestyles along with causing significant weight gain, would logically cause an increase in thromboembolic events. Cerebrovascular events in demented elderly could also be attributable to reduced movement caused by an antipsychotic. Simple laboratory testing of antipsychotic effect on coagulation profiles may elucidate whether they actually an intrinsic thrombotic effect also. The use of antidepressants also have an increased association with thromboembolic events and it would be important to clarify if the agents that cause this are the ones that cause sedation and weight gain. This may be broadened to investigate whether any medicine that causes sedation and weight gain is thrombogenic or whether the antipsychotics are unique in this respect or are more likely to cause it. Low dose aspirin may be a good preventative for such at risk patients. References at request. Competing interests: None declared