Fatal pulmonary embolism in patients on antipsychotics: case series, systematic review and meta-analysis.

Syrine Azza Manoubi, Marwa Boussaid, Oumeima Brahim, Sami Ouanes, Yosra Mahjoub, Lazhar Zarrouk, Mohamed Amin Mesrati, Abir Aissaoui

Asian journal of psychiatry 2022 Jul

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Since the 1950 s, several studies have reported that patients using first generation and/or second-generation antipsychotics had increased risk of venous thromboembolism events. These events include deep vein thrombosis and/or pulmonary embolism (PE). However, data about fatal PE in patients on antipsychotics (APs) remain scarce. Thus, the current study aimed to investigate sociodemographic, clinical and pharmacological characteristics related to psychiatric patients on APs and who died from a fatal PE. We reported a case-series, then conducted a literature review of relevant studies and performed a meta-analysis of studies with usable data. The main outcome of the study suggested a significantly high risk of fatal PE in patients using APs compared to nonusers (Odds Ratio=6.68, with 95% confidence interval 1.43-31.11). Clozapine was the most incriminated drug. Low potency first generation APs were the second most exhibited medication. Studies about the topic remain scarce with a high heterogeneity and a high probability of bias. Further studies are needed to ascertain this risk and to establish target preventive measures in this particularly vulnerable population. Copyright © 2022 Elsevier B.V. All rights reserved.

Citation

Syrine Azza Manoubi, Marwa Boussaid, Oumeima Brahim, Sami Ouanes, Yosra Mahjoub, Lazhar Zarrouk, Mohamed Amin Mesrati, Abir Aissaoui. Fatal pulmonary embolism in patients on antipsychotics: case series, systematic review and meta-analysis. Asian journal of psychiatry. 2022 Jul;73:103105