Psychotropic drugs and fatal pulmonary embolism.
OBJECTIVE
To examine the association between the use of psychotropic drugs and fatal pulmonary embolism.


METHODS
We conducted a national case-control study of fatal pulmonary embolism. Cases were 75 New Zealand men and women aged 15-59 years who died between 1 January 1990 and 31 December 1998, where the underlying cause of death was certified as codes 415.1, 451 or 453 of the International Classification of Diseases (9th Revision). Four controls, matched for sex and age, were selected from the general practice to which each case had belonged. Information was abstracted from the records of general practitioners, family planning clinics and psychiatric services. Odds ratios and 95% confidence intervals (95% CI) were estimated using conditional logistic regression. The key analyses were restricted to cases (n = 62) and controls (n = 243) without major risk factors for venous thromboembolism.


RESULTS
Compared to non-use, the adjusted odds ratio for current use of antipsychotic drugs was 13.3 (95% CI: 2.3-76.3). Low potency antipsychotics appeared to carry the highest risk (odds ratio: 20.8 [95% CI: 1.7-259.0]). The main drug involved was thioridazine. The odds ratio for current use of antidepressants was also increased, at 4.9 (95% CI: 1.1-22.5).


CONCLUSIONS
Our results for conventional antipsychotics are consistent with previous studies of non-fatal venous thromboembolism. The finding for antidepressants needs to be replicated in other studies.
Parkin
Lianne
L
Department of Preventive and Social Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.
Skegg
David C
DC
Herbison
G Peter
GP
Paul
Charlotte
C
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects; D016022:Case-Control Studies; D003024:Clozapine / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011619:Psychotropic Drugs / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality; D012307:Risk Factors; D020246:Venous Thrombosis / Q000139:chemically induced / Q000453:epidemiology
D014150:Antipsychotic Agents; D011619:Psychotropic Drugs; D003024:Clozapine