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Neuroleptics: the cause of deep vein thrombosis and pulmonary embolism

The risk of deep vein thrombosis should be taken into account before deciding to prescribe treatment with neuroleptics, and patients should be monitored.

Neuroleptics are marketed essentially to calm certain types of agitated or aggressive behaviour and to treat delirium and hallucinations. It has long been known that they can cause venous thromboembolism (phlebitis).

A major study carried out on nearly 20,000 patients aged over 65 treated with a so-called atypical neuroleptic drug showed that the risk of hospitalisation for a thromboembolic event was doubled for users of these drugs. Another study involving 42 patients who had suffered a thromboembolic event showed a sevenfold increase in the risk of thrombosis in patients under 60 using so-called classic neuroleptics. A study of 62 cases of fatal pulmonary embolism showed a thirteen-fold risk in users of classic neuroleptics.

In practice, the studies available all confirm the risk of venous thromboembolism in patients treated with neuroleptics of any kind. This risk is something that should be taken into account before deciding whether or not to prescribe a neuroleptic and in the monitoring of patients being treated.

©Prescrire September 2006

Source: "Neuroleptiques : thromboses veineuses et embolies pulmonaires" Rev Prescrire 2006 ; 26 (275) : 588-589.

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