Box 1.

Clinical recommendations for the prevention and management of venous thromboembolism (VTE) in users of antipsychotics

Patients with risk factors for VTE besides the antipsychotic treatment should be informed of VTE as a possible adverse effect, early symptoms of VTE, and the importance of seeking medical care immediately if a VTE is suspected

Early symptoms of VTE should be recognised and further investigated without delay by healthcare providers

Prevention of VTE with low-molecular weight heparin is generally considered safe and effective and should be considered in antipsychotic users restrained for more than 24 h due to psychotic uncontrollable behaviour

The threshold for initiating prophylactic treatment with low-molecular weight heparins should be low in other VTE high-risk situations (for example, fractures, surgery and reduced mobility)

A manifest VTE should be treated according to current VTE management guidelines

After a diagnosis of VTE has been made in an antipsychotic drug user, the indication of the antipsychotic treatment should be re-evaluated and treatment suspended whenever possible, or, alternatively, switched to another antipsychotic compound