Clinical Report: Rapid Development of Pulmonary Embolism After Antipsychotics

Overview

This case study highlights the rapid onset of pulmonary embolism (PE) in a 69-year-old woman shortly after initiating antipsychotic therapy. The findings emphasize the need for increased vigilance regarding venous thromboembolism (VTE) risk in psychiatric patients, even in the absence of traditional risk factors.

Background

Pulmonary embolism is a significant cause of morbidity and mortality, particularly in patients receiving antipsychotic medications. The association between antipsychotic use and increased risk of VTE, including PE, is well-documented, yet cases of very early onset remain rare. Understanding this risk is crucial for improving patient safety and management in acute psychiatric settings.

Data Highlights

No numerical data or trial data is presented in this case study.

Key Findings

• A 69-year-old woman developed acute PE within hours of starting antipsychotic therapy.
• Antipsychotic medications administered included olanzapine, quetiapine, levomepromazine, and lorazepam.
• The patient had no known predisposing risk factors for VTE.
• PE was confirmed via computed tomography pulmonary angiography.
• Successful treatment of PE was achieved with anticoagulation therapy.
• This case underscores the need for vigilance in monitoring VTE risk during the early phases of antipsychotic treatment.

Clinical Implications

Healthcare providers should be aware of the potential for rapid onset of VTE in patients starting antipsychotic medications, regardless of their risk factor profile. Regular assessment and monitoring for signs of PE should be implemented, especially in acute psychiatric settings.

Conclusion

This case illustrates the critical need for heightened awareness of VTE risks associated with antipsychotic therapy, particularly in the early treatment phase. Clinicians must remain vigilant to ensure timely diagnosis and management of potentially life-threatening conditions like pulmonary embolism.

References

1. BMC Psychiatry (Springer) — A Case Report of Serotonin Syndrome and Neuroleptic Malignant Syndrome Triggered by Sertraline and Quetiapine
2. Clinical Research in Cardiology — Unintentional Decrease in Blood Pressure in Patients with a History of Hypertension as an Indicator of Central Pulmonary Artery Embolism
3. BMC Psychiatry (Springer) — Co-occurrence of Psychotic Major Depressive Disorder and REM Sleep Behavior Disorder in a 15-Year-Old Female with a Pineal Cyst: A Case Study Featuring Neuroimaging Findings
4. BMC Psychiatry (Springer) — Unexpected Improvement of Clozapine-Related Obsessive-Compulsive Symptoms with Cariprazine Addition: A Case Study
5. 2026 Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults - Professional Heart Daily | American Heart Association
6. 2026 Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults - Professional Heart Daily | American Heart Association
7. https://www.pure.ed.ac.uk/ws/portalfiles/portal/432935634/Multiple_adverse_outcomes_MOK_DOA29022024_VOR_CC-BY.pdf