Background: Antipsychotic (AP) medications are the cornerstone treatment for schizophrenia
and some other psychiatric diseases. However, some observational studies suggest that these medications
might increase the risk of venous thromboembolism (VTE) and pulmonary embolism (PE).
Objectives: The aim of this study was to assess whether AP medications are associated with the development
of VTE or PE, and to assess the risk based on any type of AP drugs, quality of studies and after
adjustment of risk factors.
Data Sources: To identify relevant studies, we searched PubMed and EMBASE databases up to February
2019. We also searched the reference lists of relevant articles for related studies.
Study Selection: Twenty studies fulfilled the eligibility criteria and were included in our meta-analysis
after screening relevant observational cohort and case-control studies.
Primary Outcome: The primary outcome of our meta-analysis was the occurrence of all VTE or PE
only attributed to exposure to AP medications compared with non-exposure to AP medications.
Results: Exposure to AP drugs was associated with a significant increase in the risk of VTE (RR 1.53,
95% CI 1.30-1.80, I2 = 85%) and PE (RR 3.69, 95% CI 1.23-11.07, I2 = 90%). In the subgroup metaanalysis,
the use of low-potency AP drugs was associated with a higher risk of VTE, (RR 1.90, 95% CI
1.04-3.47, I2 = 78%).
Conclusion: AP exposure was associated with a 1.5-fold increase in the risk of VTE and a 3.7-fold
increase in the risk of PE. Low-potency AP drugs were associated with a higher risk of VTE. However,
high heterogeneity among studies limits the generalizability of the results.