Rare and Underestimated Association of Pulmonary Embolism and Olanzapine Therapy; Report of Two Cases Pulmonary Embolism and Olanzapine Therapy
Archives of Academic Emergency Medicine,
Vol. 9 No. 1 (2021),
1 January 2021
,
Page e17
https://doi.org/10.22037/aaem.v9i1.1063
Abstract
Abstract:
Venous thromboembolic disease (VTD) is a very common and severe pathological condition in which there are many predisposing factors. Olanzapine is a drug frequently used in psychiatric practises; it is thought to increase the risk of VTD. Here, we report two cases, a young man and a woman, with a medical history of schizophrenia treated by olanzapine who developed pulmonary embolism and we did not find any aetiologies of VTD in them. Due to the link between olanzapine and pulmonary embolism, which has been previously described, olanzapine is considered responsible for this problem. Two mechanisms have been reported in the literature in this regard; significant weight gain and lethargy, which are very common side effects of olanzapine. So far, no direct effect of olanzapine on platelet aggregation or coagulation has been found. In patients developing VTD while being treated with olanzapine, discontinuation of olanzapine as a treatment option must be done with an adjustment of antipsychotic treatment and regular monitoring of psychic symptoms. Since the diagnosis of pulmonary embolism is not easy to make in a schizophrenic patient, clinicians should take that in consideration when prescribing these drugs and when facing clinical situations where VTD is suspected.
- Pulmonary embolism
- venous thromboembolism
- risk factors
- antipsychotic agents
- olanzapine
How to Cite
References
Kannan R, Molina DK. Olanzapine: a new risk factor for pulmonary embolus? The American journal of forensic medicine and pathology. 2008;29(4):368-70.
Esmon CT. Basic mechanisms and pathogenesis of venous thrombosis. Blood reviews. 2009;23(5):225-9.
Dijkstra M, van der Weiden C, Schol-Gelok S, Muller-Hansma A, Cohen G, van den Bemt P, et al. Venous thrombosis during olanzapine treatment: a complex association. The Netherlands journal of medicine. 2018;76(6):263-8.
Grahmann H. Thombose hazard in chlorpromazine and reserpine therapy of endogenous psychosis. Nervenarzt. 1959;30:224-5.
Hägg S, Spigset O. Antipsychotic-induced venous thromboembolism. CNS drugs. 2002;16(11):765-76.
Hägg S, Bate A, Stahl M, Spigset O. Associations between venous thromboembolism and antipsychotics. Drug safety. 2008;31(8):685-94.
Almuqdadi A, Bulatova N, Yousef A-M. The effect of atypical antipsychotics on platelet aggregation. Open Journal of Hematology. 2016;7(1).
Carrizo E, Fernández V, Quintero J, Connell L, Rodríguez Z, Mosquera M, et al. Coagulation and inflammation markers during atypical or typical antipsychotic treatment in schizophrenia patients and drug-free first-degree relatives. Schizophrenia research. 2008;103(1-3):83-93.
Nederland Z. FarmacotherapeutischKompas [Available from: https://www.farmacotherapeutischkompas.nl/.
Dutch SmPC olanzapine Zalasta 2.5/5/7.5/10/15/20 tablets 2012 [26 July 2012:[Available from: https://www.ema.europa.eu/en/documents/product-information/zalasta-epar-product-information_nl.pdf.
- Abstract Viewed: 927 times
- pdf Downloaded: 302 times
