4. Results
A total of 376, 344 adverse reaction cases were reported by antipsychiatrys as preferred suspected drugs, of which 4, 455 were VTE cases. We tried to identify 43 antipsychotic drugs. However, only the following twenty-four drugs were identified: olanzapine, quetiapine, clozapine, risperidone, aripiprazole, haloperidol, paliperidone, pimavanserin, ziprasidone, lurasidone, asenapine, lithium, chlorpromazine, brexpiprazole, Iloperidone, droperidol, prochlorperazine, cariprazine, thioridazine, fluphenazine, amisulpride, ipamperone, pimozide, loxapine. The male-to-female ratio with VTE (2125/1964) was 1.08. Most VTE cases occurred in the 18 to 64-year group (64.29%). Health professionals reported 75.76% of VTEI cases. The top there VTE reporting regions were Europe (2666 cases, 59.84%), North America (1103 cases, 24.76%), and Asia (357 cases, 8.01%). The details are in Table 1. The top ten of the most reported cases of VTE antipsychotic drug are olanzapine, quetiapine and clozapine and risperidone, aripiprazole, haloperidol, paliperidone, pimavanserin, ziprasidone and lurasidone(Table 2). The data mining of FAERS suggested an association between VTE and haloperidol, olanzapine, quetiapine, and paliperidone. The RORs and the 95% confidence intervals (95% CI) of t haloperidol, olanzapine, quetiapine, and paliperidone were (ROR 2.17, 95% CI 2.17-1.91 IC 1.1 95%CI 1.52-0.66), (ROR 2.53 95% CI 2.69–2.38 IC 1.31 95%CI 1.52-1.1), (ROR 1.37, 95% CI 1.47–1.28 IC 0.45 95%CI 0.67-0.23) and (ROR 1.6 95% CI 1.83–1.4 IC 0.67 95%CI 1.11-0.22). So, clinicians should monitor patients for potential VTE while they are taking these antipsychotic drugs.
Pulmonary embolism occurred in more than 50% of VTE events (2760 cases, 52.84%), deep vein thrombosis is 24.79%(1295 cases), and Another non-standardized diagnosis of VTE is 22.36%(1168 cases) in Fig 1. It is indicated that venous thrombosis caused by antipsychotics is usually a severe consequence, which is confirmed by our analysis of the outcome, including death (883 cases), life-threatening (693 cases), hospitalization (1643 cases), and other serious events (1164 cases) in Fig 2.
Signal detection
According to the chemical structure of antipsychotics, it can be divided into butyrophenone derivatives, indole derivatives, thioxanthene derivatives, and diphenylbutylpiperidine derivatives, phenothiazines with aliphatic side-chain, phenothiazines with piperazine structure, diazepines, oxazepines, thiazepines and oxepines and lithium and other antipsychotics. Table 3 shows that Diazepines, oxazepines, thiazepines and oxepines and diphenylbutylpiperidine derivatives antipsychotics have the strongest signal in FARES. In terms of specific drugs, haloperidol, olanzapine, quetiapine and paliperidone show the strongest correlation (Table 4 for details).