Rasras Hammam, Beghi Mustapha, Samti Maryem, Ismaili Nabila, El Ouafi Noha
Department of Cardiology, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco.
Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed the First University of Oujda, Morocco.
Arch Acad Emerg Med. 2021 Feb 5;9(1):e17. doi: 10.22037/aaem.v9i1.1063. eCollection 2021.
Venous thromboembolic disease (VTD) is a very common and severe pathological condition in which there are many predisposing factors. Olanzapine is a drug frequently used in psychiatric practises; it is thought to increase the risk of VTD. Here, we report two cases, a young man and a woman, with a medical history of schizophrenia treated by olanzapine who developed pulmonary embolism and we did not find any aetiologies of VTD in them. Due to the link between olanzapine and pulmonary embolism, which has been previously described, olanzapine is considered responsible for this problem. Two mechanisms have been reported in the literature in this regard; significant weight gain and lethargy, which are very common side effects of olanzapine. So far, no direct effect of olanzapine on platelet aggregation or coagulation has been found. In patients developing VTD while being treated with olanzapine, discontinuation of olanzapine as a treatment option must be done with an adjustment of antipsychotic treatment and regular monitoring of psychic symptoms. Since the diagnosis of pulmonary embolism is not easy to make in a schizophrenic patient, clinicians should take that in consideration when prescribing these drugs and when facing clinical situations where VTD is suspected.
静脉血栓栓塞性疾病（VTD）是一种非常常见且严重的病理状况，存在许多诱发因素。奥氮平是精神科常用药物；人们认为它会增加VTD的风险。在此，我们报告两例病例，一名年轻男性和一名女性，他们有精神分裂症病史，接受奥氮平治疗，发生了肺栓塞，且我们未在他们身上发现任何VTD的病因。由于先前已描述过奥氮平与肺栓塞之间的关联，奥氮平被认为是导致该问题的原因。关于这一点，文献中报道了两种机制；显著体重增加和嗜睡，这是奥氮平非常常见的副作用。到目前为止，尚未发现奥氮平对血小板聚集或凝血有直接影响。在用奥氮平治疗期间发生VTD的患者中，作为一种治疗选择，停用奥氮平的同时必须调整抗精神病治疗并定期监测精神症状。由于精神分裂症患者中肺栓塞的诊断不易做出，临床医生在开具这些药物时以及面对怀疑有VTD的临床情况时应予以考虑。
