Abstract
Objective: Venous thromboembolism (VTE) is a serious multifactorial disorder. Both inherited and acquired factors play a role in its ethiopathogenesis.
Patients with severe mental illness have higher risk of developing the disorder compared to general population. Methods: We observed ten cases of VTE in patients with mental illness treated with antipsychotic drug olanzapine.
The diagnosis of VTE was made at the University hospital Hradec Kralove (UK HK) in years 2004-2013. VTE was objectively proved by imaging techniques (duplex ultrasonography, CT angiography) and laboratory tests (D-dimer).
There were 3 women in the patient group. Average age was 46 years.
VTE developed during the hospitalization in three cases. The clinical manifestation of VTE was deep vein thrombosis in 9 cases, including one case of simultaneous pulmonary embolism and 1 case of concurrent ischemic cerebrovascular accident (iCVA).
All patients were free from the history of malignant disease, trauma or surgery. Results: Apart from antipsychotic medication, there were clinical or laboratory risk factors for VTE present in all the patients.
The most frequent clinical risk factors were obesity (n=7) and smoking (n=6), respectively. The most frequent laboratory risk factors were increased levels of F VIII (n=4), mild hyperhomocysteinemia (n=3) and factor V Leiden mutation (n=2), respectively.
VTE developed within 3 months from the antipsychotic drug initiation in three patients and within 6 months from the antipsychotic initiation in other three patients. Conclusion: We described a group of 10 patients with VTE manifestation during the olanzapine treatment.
However, there were other clinical or laboratory risk factors detected in all the cases. Olanzapine can be considered as precipitating factor regarding VTE formation.
When admínistered, we need to monitor clinical signs and symptoms of VTE, moreover when other risk factors are present.