Association between antipsychotics and pulmonary embolism: a pharmacovigilance analysis

Area of Science:

• Pharmacovigilance
• Clinical Epidemiology
• Psychiatry

Background:

• Previous research suggests a link between antipsychotics (APs) and an increased risk of pulmonary embolism (PE) in schizophrenia patients.
• Real-world data specifically investigating this association remain limited.

Purpose of the Study:

• To investigate the potential relationship between antipsychotic use and pulmonary embolism.
• To analyze the risk and outcomes of PE associated with various antipsychotics.

Main Methods:

• Utilized the Food and Drug Administration Adverse Event Reporting System (FAERS) database from Q1 2018 to Q1 2023.
• Collected and analyzed cases of PE suspected to be induced by APs using disproportionality analysis and reporting odds ratio (ROR).
• Examined mortality, life-threatening events, and hospitalizations for each AP.

Main Results:

• Included 1,676 cases of PE related to APs, demonstrating a significant association (ROR 2.00).
• Commonly associated APs included quetiapine, olanzapine, aripiprazole, clozapine, risperidone, and haloperidol.
• The median onset time for PE was 29 days, with 20.7% of cases resulting in death; haloperidol showed a higher mortality rate (53.2%).

Conclusions:

• Antipsychotic medications may increase the risk of pulmonary embolism in patients diagnosed with schizophrenia.
• Specific antipsychotics exhibit varying degrees of association with PE and associated mortality.