Antipsychotic Use and Idiopathic Venous Thromboembolism

Research Critique
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Introduction
Antipsychotics are a class of medical drugs which are primarily used in medication process
and management of psychosis conditions such as hallucinations, paranoia, disorder, and
delusions. It has been increasingly used in the management of nonpsychotic. The drugs are
often useful in effective relief of pain and symptoms for short duration of time. First
generation antipsychotics are referred to as do pine receptor antagonists- DRA. These drugs
include acetophenazine, dibenzoxazepines, perphenazine, prochlorperazine, acetophenazine
and many more [1].
The second generation antipsychotic drugs include serotonin-dopamine antagonists which are
generally antipsychotics. Currently, FDA organization have approved 12 types of atypical
antipsychotics. They include ziprasidone, iloperidone, paliperidone, asenapine, quetiapine,
aripiprazole, paliperidone, brexpiprazole, and clozapine [2].
These drugs have been utilized for various indications. The first and second generation
antipsychotic drugs are used for the management of schizophrenia and schizoaffective states
for the management of acute episodes of psychosis and therapy maintenance. First
generations have shown better and effective means of treating symptoms of hallucinations
among others, further they lower the risks of repeated episodes of psychosis.
First generation drugs have shown improved care on managing acute mania with psychotic
symptoms. Second generation drugs except clozapine are effective in the management of
acute symptoms of acute mania. They mostly used with mood stabilizers drugs such as
lithiumcarbamezipaine and valproic acid. Further, first and second generation drugs have
shown effectiveness in treating and managing major depressive disorders with antidepressant
being the treatment of choice for depression with psychotic features. Other indications of first
and second generation include management of borderline disorders, Tourette disorders;
dementia and delirium and managing the substance-induced psychotic disorder. Clozapine
has been used often when a patient fail to yield the needed results in various trials [4].
The first generation of drugs works by an inhibitor of the dopaminergic neurotransmission.
They effectively block about 72% of the D2 dopamine receptors located in the brain. Further,
they consist of noradrenergic, cholinergic and histaminergic effect action. The second
generation drugs act by blocking the receptors of Dopamine D2 together with serotonin

receptor action. The 5-HT2A subtype of serotonin is commonly used. The associative adverse
effects have been noted with extrapyramidal side effects. Anticholinergic effects dry mouth,
urine retention and constipation [1].
Strengths and limitations of the study
The study assessed recipient’s subjects of antipsychotic use, below the aged 60 years.
Computer generated medical diagnosis were assessed. The study strengths entailed diagnoses
generated using computer diagnosis records. Further verification process was undertaken,
letters were sent to the hospital facility to confirm their admission thus eliminating omission
error. Inclusion criteria entailed a positive diagnosis of venous thromboembolism impedance
plethysmography, venogram, ultrasonography, or doppler test, and pulmonary embolism
through confirmation of ventilation-perfusion scan. Further, the stud methodology excluded
discharge summaries subjects with previous venous thromboembolism and history of trauma,
pregnancy or surgery history in the 6 months.
The study, however, despite its findings’ between conventional antipsychotic drugs and
venous thromboembolism is consistent with other research little information is provided
between the relation of atypical; antipsychotic and idiopathic venous thromboembolism. Thus
could not create an effective causality. Thus, making it a limitation for none generalization of
the results.
Critical appraisal
Event definition and applied methods
The studies previously conducted have shown that conventional antipsychotic drugs are not
free from cardiovascular and other risks factors and other spontaneous reports did not provide
controls [5]. Antipsychotic drugs are common medication management drugs with the
potential fatal occurrence of venous thromboembolisms public health hazard. These study
employed population-based approach nets control analysis to identify the relationship
between antipsychotic drugs and management of risk of development of the first episode,
idiopathic venous thromboembolism in the bigger cohort using UK based general practice
research database.
Exposure definition and methods applied