Key result
Typical antipsychotics and >10 years use linked to slightly elevated PAI-1 and fibrinogen versus atypical agents.
Why the study?
The role of antipsychotic medication type and duration of use on disturbances in the hemostatic system in patients with major mental illnesses is poorly understood.
Does the type and duration of antipsychotic use affect plasma levels of fibrinogen and PAI-1 in patients with major mental illnesses?
Observational (n=124)
Does the type and duration of antipsychotic use affect plasma levels of fibrinogen and PAI-1 in patients with major mental illnesses?
Typical antipsychotics and prolonged use (>10 years) are associated with slightly elevated prothrombotic markers (PAI-1 and fibrinogen) in patients with major mental illnesses, suggesting a potential increased risk for venous thromboembolism.
These associations should not yet change practice; leaves open whether typical or prolonged antipsychotic use increases VTE risk.
Background: Disorders of the hemostatic system such as hypercoagulation and hypofibrinolysis are clinical manifestations in patients with schizophrenia, depression, and bipolar disorder. However, the role of the type of antipsychotic medication as well as the duration of use on disturbances in the hemostatic system is poorly understood. This study was, therefore, carried out to determine the possible impact of antipsychotic treatment as well as the duration of use on selected acute-phase proteins involved in coagulation and fibrinolysis. Materials and Methods: Plasma levels of fibrinogen and plasminogen activator inhibitor-1 (PAI-1) were determined in 124 patients with major mental illnesses: schizophrenia, depression, and bipolar disorder. Thereafter, the participants were grouped based on the type of antipsychotic medication (typical vs. atypical) and the duration of antipsychotic use. Results: Patients on typical antipsychotics had a slightly elevated level of PAI-1 but a similar level of fibrinogen when compared with patients on atypical antipsychotics. Furthermore, the median plasma levels of fibrinogen and PAI-1 in patients who have been on antipsychotic use for more than 10 years were slightly higher than in patients who have been on the drug for 10 years or less. Conclusion: It could be concluded from this study that patients on typical antipsychotics and those who have used any form of antipsychotics for more than 10 years might benefit from periodic assessment of markers of prothrombosis as it could facilitate early identification of those at risk of venous thromboembolism.
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Rahamon et al. (2020) conducted an observational in Major mental illnesses (schizophrenia, depression, and bipolar disorder) (n=124). Typical antipsychotics and >10 years of antipsychotic use vs. Atypical antipsychotics and ≤10 years of antipsychotic use was evaluated on Plasma levels of fibrinogen and plasminogen activator inhibitor-1 (PAI-1). Typical antipsychotics and antipsychotic use for >10 years were associated with slightly elevated plasma levels of PAI-1 and fibrinogen compared to atypical agents and shorter duration of use.
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