Pulmonary Embolism Related to Amisulpride Treatment: A Case Report

Σκώκου, Μαρία; Gourzis, Philippos

doi:10.1155/2013/718950

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Numerous papers report a connection between treatment with neuroleptics and venous thrombosis, but the exact mechanism of this association is not known. The level of prolactin in plasma was increased in the case shown as thromboembolism in a patient treated with amisulpiride 6 . Antipsychotics are generally dopaminergic antagonists resulting in the increased level of prolactin 7 .…”

Section: Discussionmentioning

confidence: 89%

Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

Marinkovic

Rancic

2017

VOJNOSANIT PREGL

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Introduction. Pulmonary thromboembolism occurs usually by running a thrombus from the deep veins of the legs rarely periprostatic or periuteric veins. Virchow's triad of necessary conditions for the occurrence of thrombosis involves disruption of blood flow, disruption of blood chemistry and damage to the vessel wall. Venous thrombosis is often associated with the implementation of antipsychotic therapy. Case report. We reported two cases of sudden death of psychiatric patients who were in both cases fixed during hospitalization. The first case was a 26-year-old woman treated a year with the diagnose of postpartum reactive psychosis. She was hospitalized because of mental state worsening with a dominant depressed mood, visual and auditory hallucinations. Her therapy was determined by diazepam, clozapine, haloperidol and lamotrigine. Suddenly, the patient died on the fifth day of hospitalization. The autopsy showed massive thromboembolism of the pulmonary artery branches. Toxicological analysis revealed the presence of therapeutic doses of antipsychotics. The second case was a-45-yearold men, a long-time alcoholic. On admission, the diagnosis of delirium tremens was established, and diazepam and haloperidol were administered. On the fifth day of hospitalization, he suddenly died. The autopsy showed thromboembolism of the branch of the pulmonary artery. Toxicological analysis established the presence of nordiazepam in urine (0.06 mg/L). Both patients were fixed during hospitalization. Conclusion. Both presented psychiatric patients were younger than 50 years, were not overweight, did not have changes of the venous blood vessels. Nowadays, when the issue of medical responsibility often arises in these and similar cases of sudden death in patients treated in psychiatric clinics, the questions on medical malpractice could be expected.

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Section: Discussionmentioning

confidence: 89%

Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

Marinkovic

Rancic

2017

VOJNOSANIT PREGL

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“…Recently, Skokou and Gourzis 29 reported a case of pulmonary embolism in a woman with bipolar disorder who was treated with amisulpride, aripiprazole, and paroxetine. Although the contribution of aripiprazole and paroxetine cannot be excluded completely, the most likely factor underlying the thromboembolic event was hyperprolactinemia (92 ng/mL) caused by the amisulpride.…”

Section: Introductionmentioning

confidence: 99%

Hyperprolactinemia during antipsychotics treatment increases the level of coagulation markers

Ishioka

Yasui‐Furukori

Sugawara

et al. 2015

NDT

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ObjectiveThe strong association between psychiatric patients who receive antipsychotics and the incidence of venous thromboembolism (VTE) is known. Although previous reports suggest that hyperprolactinemia often increases markers of activated coagulation, few studies have examined the direct relationship between the prolactin level elevated by antipsychotics and activated markers of activated coagulation.MethodThe participants included 182 patients with schizophrenia (male =89, female =93) who received antipsychotic treatments for at least 3 months. Markers of VTE (D-dimer, fibrin/fibrinogen degradation products, and thrombin–antithrombin complex) and serum prolactin concentrations were measured.ResultsProlactin levels were significantly correlated with the logarithmic transformation of the D-dimer (r=0.320, P=0.002) and fibrin/fibrinogen degradation product levels (r=0.236, P=0.026) but not of the thrombin–antithrombin complex level (r=0.117, ns) among men. However, no correlations were found between the VTE markers and prolactin levels among women. These results were confirmed using multiple regression analyses that included demographic factors and antipsychotic dosages.ConclusionThe current study indicates that hyperprolactinemia is associated with an increase in markers of activated coagulation among men receiving antipsychotics. This finding clinically implies that monitoring and modulating prolactin levels among men are important to decrease the risk of VTE.

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Venous thromboembolism as an adverse effect of antipsychotic treatment

Bałkowiec-Iskra¹,

Cessak²,

Kryńska³

et al. 2014

Psychiatr Pol

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Wiele badań wskazuje na istnienie związku pomiędzy stosowaniem leków przeciwpsychotycznych (LPP) a występowaniem żylnej choroby zakrzepowo-zatorowej (VTE). Powikłania zakrzepowo-zatorowe obarczone są istotnym ryzykiem inwalidyzacji i zgonu, są również czynnikiem znacznie zwiększającym koszty leczenia. Pomimo wieloletnich badań, mechanizmy zależności pomiędzy stosowaniem LPP, a rozwojem VTE nie zostały do tej pory dokładnie wyjaśnione, jednak najprawdopodobniej łączą się z zagadnieniem nadumieralności pacjentów psychiatrycznych. Celem pracy było podsumowanie dotychczasowych doniesień dotyczących czynników ryzyka wystąpienia VTE u pacjentów stosujących leki LPP. W pracy oparto się na wynikach badań klinicznych, metaanaliz, przeglądów systematycznych oraz danych Europejskiej Agencji Leków. Na podstawie analizowanych doniesień ustalono, że do głównych czynników ryzyka wystąpienia VTE należy czas stosowania leczenia oraz czynniki związane z pacjentem, takie jak płeć, wiek, masa ciała oraz aktywność fizyczna. Dotychczasowe dane nie pozwalają na jednoznaczne zróżnicowanie potencjału prozakrzepowego poszczególnych LPP, jak również na wykazanie wyższego ryzyka VTE u chorych leczonych atypowymi LPP. Ze względu na złożoną patogenezę VTE konieczne jest przeprowadzenie dużych badań porównawczych, mogących doprecyzować różnice w prozakrzepowym działaniu poszczególnych LPP. Celowym wydaje się również wyodrębnienie produktów o najniższym ryzyku wywoływania VTE, które będzie można stosować u pacjentów obarczonych wysokim ryzykiem VTE, tym samym zwiększając bezpieczeństwo terapii. Wszystkich chorych leczonych LPP należy oceniać pod kątem ryzyka rozwoju powikłań zakrzepowo - zatorowych, wdrażać odpowiednią profilaktykę (obejmującą przede wszystkim wyeliminowanie modyfikowalnych czynników ryzyka) oraz edukować w zakresie objawów mogących przemawiać za rozwojem VTE. Każdy chory z podejrzeniem VTE powinien mieć przeprowadzoną jak najszybszą diagnostykę i wdrożone leczenie.

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Pulmonary Embolism Related to Amisulpride Treatment: A Case Report

Cited by 4 publications

References 29 publications

Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

Hyperprolactinemia during antipsychotics treatment increases the level of coagulation markers

Venous thromboembolism as an adverse effect of antipsychotic treatment

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Pulmonary Embolism Related to Amisulpride Treatment: A Case Report

Cited by 4 publications

References 29 publications

Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

Pulmonary thromboembolism and sudden death in psychiatric patients: Two cases reports

Hyperprolactinemia during antipsychotics treatment increases the level of coagulation&nbsp;markers

Venous thromboembolism as an adverse effect of antipsychotic treatment

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Hyperprolactinemia during antipsychotics treatment increases the level of coagulation markers