Abstract
Venous thromboembolism (VTE) in patients treated with antipsychotic medication has been documented from its beginning in the 1950s. An increased attention has been paid to this topic in the last decade.
Recent scientific evidence is mostly based on observational studies and case report series. An increased risk for VTE is associated with therapy with clozapine or low potency first generation antipsychotics.
In addition to this, reports on VTE induced by other second generation antipsychotics (olanzapine, risperidon) become more frequent in the literature. The most important risk of a pathological blood clotting occurs in the first three months after the antipsychotic drug is prescribed.
Sedation, obesity, antiphospholipid antibodies, increased activation and aggregation of thrombocytes, hyperhomocysteinemia and hyperporlactinemia belong to possible etiopathogenetic factors in venous thromboembolism. The diagnosis of schizophrenia or bipolar affective disorder itself, hospitalization or stress with activation of the sympatic nerve and increase in catecholamine blood level also act as prothrombogenic factors.
Prospective studies are necessary to clarify biological mechanisms involved in the association of antipsychotics with venous thromboembolism.