Deep venous thrombosis and atypical antipsychotics: three cases report

In this paper three cases of deep venous Thrombosis (DVT) following the use of olanzapine and risperidone are presented.The data of Three patients was collected from hospital records.The patients were in good general physical health and had no personal or familial history of DVT. The patients were not overweight (BMI？<？25) but they suffered from DVT after initiating risperidone and olanzapine.Risk of DVT exists in patients under treatment with atypical antipsychotics in spite of no pre existing risk factor.Deep venous thrombosis (DVT) and pulmonary embolism (PE) are frequent illnesses with an annual incidence of 1 per 1000 persons and a mortality rate above 15% in the first 3？months after diagnosis [1]. Risk of DVT is relatively more in psychiatric patients rather than people who are mentally healthy [2], especially in Paients suffering from schizophrenia and bipolar disorder [3]. In a case reported by Zornberg & Jick, a significantly increased risk of DVT was seen in patients receiving first generation antipsychotics, particularly in the first months of the treatment [4]. It is believed that Antipsychotics may induce pathological blood clotting via sedating them as well as reducing motor activity, metabolic Syndrome such as obesity and hyperprolactinemia [5].The patients’ sedation, immobilization or psychopathological symptoms, often interfere with the diagnosis of DVT, therefore, it may not always be recognized at first [6].In this report three psychiatric patients who developed DVT after using olanzapine and risperidon are presented. No personal and familial history of DVT was found in these cases. Nevertheless, their condition suggests a possible association between atypical antipsychotics and DVT in the absence of any pre- existing risk factors. Written informed consents were obtained from the patients for publication of this report.The patient was a 38- year- old female with a diagnosis of depressive episode in course of bipolar 1 disorder,according to DSM-IV-