Antipsychotics
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Antipsychotics Hyperprolactinaemia and pulmonary thromboembolism: 7 case reports
A retrospective study identified six women and one man, aged 31–63 years, who developed pulmonary thromboembolism while receiving antipsychotics [routes not stated] for schizophrenia. Hyperprolactinaemia was apparent in six of the patients [see table]. The patients were receiving 1–3 antipsychotic drugs, including chlorpromazine, clozapine, fluphenazine, haloperidol, olanzapine, risperidone and thioridazine, at a daily dose of 4–300mg. Duration of treatment with antipsychotics ranged from 3 to 28 years. At the time of hospitalisation, all patients were normotensive and afebrile. Chest CT scans disclosed massive bilateral thromboembolism in four patients, and thromboembolism of the terminal part of the left pulmonary artery, the segmental branch of the left pulmonary artery and the right lower pulmonary vein in three patients, respectively. A high level of prolactin was detected in six patients. They were hospitalised for 6–82 days. [Outcomes not stated].
Patient characteristics Patient/sex/ age (y) 1/M/31
2/F/58 3/F/51 4/F/53 5/F/53 6/F/63 7/F/61
Antipsychotics (daily dose in mg)
Prolactin level elevated
chlorpromazine (300), olanzapine (10), haloperidol (15) thioridazine (75), haloperidol (15) clozapine (300), risperidone (4) fluphenazine (5), clozapine (300) clozapine (300), haloperidol (15) clozapine (300), haloperidol (50) clozapine (200)
yes
yes yes yes no yes yes
Author comment: "Clinicians must be very careful about antipsychotic drug treatment and should evaluate level of prolactine because vascular risk factors may interact with antipsychotics in terms of increasing the risk of [pulmonary thromboembolism]." Fisekovic S, et al. Is hyperprolactinemia a risk factor for pulmonary thromboembolism (PTE) in patients treated with antipsychotic drugs? HealthMED 803079205 6: 2234-2238, No. 6, 2012 - Bosnia-Herzegovina
0114-9954/10/1426-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 3 Nov 2012 No. 1426
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