ppanPersonalized Psychiatry and NeurologyPersonalized Psychiatry and Neurology2712-9179V. M. Bekhterev National Medical Research Centre for Psychiatry and Neurology of the Ministry of Health of the Russian Federation (Bekhterev NMRC PN)10.52667/2712-9179-2026-6-2-10-28ppan-177Research ArticleREVIEWChanges in Platelet Level and Activation as Hematological Biomarkers of Antipsychotic-Induced Systemic Inflammatory Response: Narrative ReviewNasyrovaRegina F.

3 Bekhterev St., St Petersburg 192019

regina_nmrcpn@mail.ruShnayderNatalia A.

3 Bekhterev St., St Petersburg 192019

naschnaider@yandex.ruAbramenkoAnastasiia A.

3 Bekhterev St., St Petersburg 192019

TaygibovaZarema T.

3 Bekhterev St., St Petersburg 192019

GuseynovElmar O.

3 Bekhterev St., St Petersburg 192019

Institute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyRussian Federation202624062026621028Copyright © Nasyrova R.F., Shnayder N.A., Abramenko A.A., Taygibova Z.T., Guseynov E.O., 20262026Nasyrova R.F., Shnayder N.A., Abramenko A.A., Taygibova Z.T., Guseynov E.O.Nasyrova R.F., Shnayder N.A., Abramenko A.A., Taygibova Z.T., Guseynov E.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jppn.ru/jour/article/view/177

Research over the last decade has shown that schizophrenia spectrum disorders (SSDs) cannot be viewed exclusively as a neurotransmitter pathology. A significant proportion of patients, especially those in the acute phase and with treatment resistance, exhibit signs of low-grade inflammation (LGI), which is associated with cardiovascular comorbidity, including the risk of venous thromboembolism (VTE). The role of antipsychotics (APs), which are the mainstay of SSDs therapy, in the development of VTE remains controversial. On one hand, preclinical in vitro and in vivo studies demonstrate an antiplatelet effect of APs. This effect is mediated through blockade of adenosine diphosphate (P2Y1 and P2Y2) and serotonin (5-HT2A) receptors, and inhibition of thromboxane A2. On the other hand, clinical in vivo studies indicate the persistence or even increase of procoagulant platelet activity and LGI, which significantly elevates the risk of VTE in patients with SSDs during long-term AP treatment. Materials and Methods: In this narrative review, we analyzed and summarized the results of preclinical and clinical studies on biomarkers of AP-induced platelet activation, as well as their prognostic role in assessing VTE risk in patients with SSDs. Results: As a result, the knowledge of psychiatrists regarding the potential negative impact on platelet hemostasis has been updated for firstand new-generation APs. It has been shown that asenapine and amisulpride carry the highest risk of developing AP-induced VTE. Haloperidol and droperidol have a dose-dependent risk of VTE. An increased risk of AP-induced pathological bleeding is observed with the use of quetiapine, thioridazine, thiothixene, and flupentixol. Conclusion: The diverse effects of APs on platelet hemostasis have been demonstrated. This underscores the need for a differentiated approach to selecting APs and the complexity of predicting the additive effect during AP polytherapy. Dynamic monitoring of hematological biomarkers (platelet and inflammatory) is important for reducing the risk of developing VTE in patients with SSDs.

plateletsschizophrenia spectrum disordersantipsychotichematological biomarkerplatelet hemostasislow-grade inflammationvenous thromboembolismpulmonary embolismpathological bleedinghematological adverse reaction.The study was performed within the framework of the state assignment of the ”Bekhterev’s National Medical Research Center for Psychiatry and Neurology of the Ministry of Health of Russia” (XSOZ 2024 0012).ReferencesJi G.J., Zalesky A., Wang, Y., et al. Linking personalized brain atrophy to schizophrenia network and treatment response. Schizophrenia Bulletin. 2023; 49(1):43–52. https://doi.org/10.1093/schbul/sbac162Ji G.J., Zalesky A., Wang, Y., et al. Linking personalized brain atrophy to schizophrenia network and treatment response. Schizophrenia Bulletin. 2023; 49(1):43–52. https://doi.org/10.1093/schbul/sbac162Yu Q., Weng W., Zhou H., et al. Elevated platelet parameter in first-episode schizophrenia patients: a cross-sectional study. Journal of Interferon & Cytokine Research. 2020; 40(11): 524–529. https://doi.org/10.1089/jir.2020.0117Yu Q., Weng W., Zhou H., et al. Elevated platelet parameter in first-episode schizophrenia patients: a cross-sectional study. Journal of Interferon & Cytokine Research. 2020; 40(11): 524–529. https://doi.org/10.1089/jir.2020.0117Manoubi S.A., Boussaid M., Brahim O., et al. Fatal pulmonary embolism in patients on antipsychotics: case series, systematic review and meta-analysis. Asian Journal of Psychiatry. 2022; 73,103105. https://doi.org/10.1016/j.ajp.2022.103105Manoubi S.A., Boussaid M., Brahim O., et al. Fatal pulmonary embolism in patients on antipsychotics: case series, systematic review and meta-analysis. Asian Journal of Psychiatry. 2022; 73,103105. https://doi.org/10.1016/j.ajp.2022.103105Chari D., Sawhney I., Mukaetova-Ladinska E., et al. Risk factors for deep vein thrombosis and pulmonary embolism: a comparative study between acute hospital care and mental health inpatient settings for older people. Working with Older People. 2025; 29(3):254–265. https://doi.org/10.1108/WWOP-06-2024-0031Chari D., Sawhney I., Mukaetova-Ladinska E., et al. Risk factors for deep vein thrombosis and pulmonary embolism: a comparative study between acute hospital care and mental health inpatient settings for older people. Working with Older People. 2025; 29(3):254–265. https://doi.org/10.1108/WWOP-06-2024-0031Osimo E.F., Perry B.I., Cardinal R.N., et al. Inflammatory and cardiometabolic markers at presentation with first episode psychosis and long-term clinical outcomes: a longitudinal study using electronic health records. Brain, Behavior, and Immunity. 2021; 91:117-127. https://doi.org/10.1016/j.bbi.2020.09.011Osimo E.F., Perry B.I., Cardinal R.N., et al. Inflammatory and cardiometabolic markers at presentation with first episode psychosis and long-term clinical outcomes: a longitudinal study using electronic health records. Brain, Behavior, and Immunity. 2021; 91:117-127. https://doi.org/10.1016/j.bbi.2020.09.011Li H., Li W., Zhang X., et al. Association of antipsychotic drugs with venous thromboembolism in patients with schizo-phrenia: a systematic review and meta-analysis. General Psychiatry. 2023; 36(5):e101347. https://doi.org/10.1136/gpsych-2023-101347Li H., Li W., Zhang X., et al. Association of antipsychotic drugs with venous thromboembolism in patients with schizo-phrenia: a systematic review and meta-analysis. General Psychiatry. 2023; 36(5):e101347. https://doi.org/10.1136/gpsych-2023-101347Khoodoruth M.A.S., Tarteel H., Sami O., et al. Peripheral inflammatory and metabolic markers as potential biomarkers in treatment-resistant schizophrenia: insights from a Qatari cohort. Psychiatry Research. 2025; 344:116307. https://doi.org/10.1016/j.psychres.2024.116307Khoodoruth M.A.S., Tarteel H., Sami O., et al. Peripheral inflammatory and metabolic markers as potential biomarkers in treatment-resistant schizophrenia: insights from a Qatari cohort. Psychiatry Research. 2025; 344:116307. https://doi.org/10.1016/j.psychres.2024.116307Ekwere T.A., Effiong J.H. Assessing the risk of venous thromboembolism in psychiatric patients on antipsychotic medication using platelet indices. International Journal of Medical and Health Sciences. 2017;6(3):134-138. https://doi.org/10.9790/6737-0603134138Ekwere T.A., Effiong J.H. Assessing the risk of venous thromboembolism in psychiatric patients on antipsychotic medication using platelet indices. International Journal of Medical and Health Sciences. 2017;6(3):134-138. https://doi.org/10.9790/6737-0603134138Zhdanov R.I., Doinikova A.N., Zhdanova S.I., et al. Correlation between haemostatic and vegetate nervous system param-eters under examination stress. Zhurnal Vyssheinervnoi Deiatelnosti imeni I. P. Pavlova. 2016; 66(2):202–208. (In Russian)Zhdanov R.I., Doinikova A.N., Zhdanova S.I., et al. Correlation between haemostatic and vegetate nervous system param-eters under examination stress. Zhurnal Vyssheinervnoi Deiatelnosti imeni I. P. Pavlova. 2016; 66(2):202–208. (In Russian)Brusov O.S., Karpova N.S., Oleichik I.V., et al. The decrease in procoagulant activity of blood during combined therapy with antidepressants and antipsychotics in patients with endogenous mental disorders. Zh. Nevrol. Psikhiatr. Im. S. S. Korsakova. 2021; 121(4):30-36. https://doi.org/10.17116/jnevro202112104130 (in Russian)Brusov O.S., Karpova N.S., Oleichik I.V., et al. The decrease in procoagulant activity of blood during combined therapy with antidepressants and antipsychotics in patients with endogenous mental disorders. Zh. Nevrol. Psikhiatr. Im. S. S. Korsakova. 2021; 121(4):30-36. https://doi.org/10.17116/jnevro202112104130 (in Russian)Morozova M.A., Burminsky D.S., Beniashvili A.G., et al. Association of the effectiveness of therapy for an acute psychotic episode in patients with schizophrenia with the activity of platelet enzymes. Psikhiatriya. 2023; 21(3):6-15. https://doi.org/10.30629/2618-6667-2023-21-3-6-15 (in Russian)Morozova M.A., Burminsky D.S., Beniashvili A.G., et al. Association of the effectiveness of therapy for an acute psychotic episode in patients with schizophrenia with the activity of platelet enzymes. Psikhiatriya. 2023; 21(3):6-15. https://doi.org/10.30629/2618-6667-2023-21-3-6-15 (in Russian)Zheng Y., Zhou X., Chen K., et al. Neutrophil/lymphocyte ratio is increased in the acute phase of schizophrenia and re-gardless the use and types of antipsychotic drugs. BMC Psychiatry. 2024; 24(1): 876. https://doi.org/10.1186/s12888-024-06330-wZheng Y., Zhou X., Chen K., et al. Neutrophil/lymphocyte ratio is increased in the acute phase of schizophrenia and re-gardless the use and types of antipsychotic drugs. BMC Psychiatry. 2024; 24(1): 876. https://doi.org/10.1186/s12888-024-06330-wKosidou S., Zannas Z., Ofrydopoulou A., et al. Psychotropic and neurodegenerative drugs modulate platelet activity via the PAF pathway. Neurochemistry International. 2025; 191:106073. https://doi.org/10.1016/j.neuint.2025.106073Kosidou S., Zannas Z., Ofrydopoulou A., et al. Psychotropic and neurodegenerative drugs modulate platelet activity via the PAF pathway. Neurochemistry International. 2025; 191:106073. https://doi.org/10.1016/j.neuint.2025.106073Wu, C.C., Tsai, F.M., Chen, M.L., et al. Antipsychotic drugs inhibit platelet aggregation via p2y1 and p2y12 receptors. Biomed Res Int. 2016; 2016: 2532371. https://doi.org/10.1155/2016/2532371Wu, C.C., Tsai, F.M., Chen, M.L., et al. Antipsychotic drugs inhibit platelet aggregation via p2y1 and p2y12 receptors. Biomed Res Int. 2016; 2016: 2532371. https://doi.org/10.1155/2016/2532371Zheng C., Liu H., Tu W., et al. Hypercoagulable state in patients with schizophrenia: different effects of acute and chronic antipsychotic medications. Therapeutic Advances in Psychopharmacology. 2023; 13: 20451253231200257. https://doi.org/10.1177/20451253231200257Zheng C., Liu H., Tu W., et al. Hypercoagulable state in patients with schizophrenia: different effects of acute and chronic antipsychotic medications. Therapeutic Advances in Psychopharmacology. 2023; 13: 20451253231200257. https://doi.org/10.1177/20451253231200257State Register of Medicines. Available at: https://grls.pharm-portal.ru/grlsState Register of Medicines. Available at: https://grls.pharm-portal.ru/grlsU.S. Food and Drug Administration (FDA). Available at: https://www.fda.govU.S. Food and Drug Administration (FDA). Available at: https://www.fda.govWallaschofski H., Eigenthaler M., Kiefer M., et al. Hyperprolactinemia in patients on antipsychotic drugs causes adp-stimulated platelet activation that might explain the increased risk for venous thromboembolism: pilot study. Journal of Clinical Psychopharmacology. 2003; 23(5):479-483. https://doi.org/10.1097/01.jcp.0000088914.24613.51Wallaschofski H., Eigenthaler M., Kiefer M., et al. Hyperprolactinemia in patients on antipsychotic drugs causes adp-stimulated platelet activation that might explain the increased risk for venous thromboembolism: pilot study. Journal of Clinical Psychopharmacology. 2003; 23(5):479-483. https://doi.org/10.1097/01.jcp.0000088914.24613.51National Center for Biotechnology Information (NCBI). Glycoprotein IIb/IIIa Inhibitors. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK554376/National Center for Biotechnology Information (NCBI). Glycoprotein IIb/IIIa Inhibitors. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK554376/Ogłodek, E.A., Just, M.J., Grzesińska, A.D., et al. The impact of antipsychotics as a risk factor for thromboembolism. Phar-macological Reports. 2018; 70(3): 533-539. https://doi.org/10.1016/j.pharep.2017.12.003Ogłodek, E.A., Just, M.J., Grzesińska, A.D., et al. The impact of antipsychotics as a risk factor for thromboembolism. Phar-macological Reports. 2018; 70(3): 533-539. https://doi.org/10.1016/j.pharep.2017.12.003Patrono C., Rocca B. Measurement of thromboxane biosynthesis in health and disease. Front. Pharmacol. 2019; 10:1244. https://doi.org/10.3389/fphar.2019.01244Patrono C., Rocca B. Measurement of thromboxane biosynthesis in health and disease. Front. Pharmacol. 2019; 10:1244. https://doi.org/10.3389/fphar.2019.01244Takada Y.K., Wu C.Y., Takada Y. PF4 autoantibody complexes cause activation of integrins αiibβ3 and αvβ3 and possible subsequent thrombosis and autoimmune diseases. Int. J. Mol. Sci. 2025; 26(21):10260. https://doi.org/10.3390/ijms262110260Takada Y.K., Wu C.Y., Takada Y. PF4 autoantibody complexes cause activation of integrins αiibβ3 and αvβ3 and possible subsequent thrombosis and autoimmune diseases. Int. J. Mol. Sci. 2025; 26(21):10260. https://doi.org/10.3390/ijms262110260Patti G., Nenna A., Spadoni F., et al. β-thromboglobulin as a biomarker of platelet activation and predictor of cardiovascular events: a systematic review and meta-analysis. Stroke. 2025; 56(3): 712-723. https://doi.org/10.1161/STROKEAHA.124.049972Patti G., Nenna A., Spadoni F., et al. β-thromboglobulin as a biomarker of platelet activation and predictor of cardiovascular events: a systematic review and meta-analysis. Stroke. 2025; 56(3): 712-723. https://doi.org/10.1161/STROKEAHA.124.049972Marengo M., Migliori M., Merlotti G., et al. Role of the cd40-cd40 ligand pathway in cardiovascular events, neurological alterations, and other clinical complications of chronic hemodialysis patients: protective role of adsorptive membranes. Blood Purification. 2023; 52(1): 27-42. https://doi.org/10.1159/000530808Marengo M., Migliori M., Merlotti G., et al. Role of the cd40-cd40 ligand pathway in cardiovascular events, neurological alterations, and other clinical complications of chronic hemodialysis patients: protective role of adsorptive membranes. Blood Purification. 2023; 52(1): 27-42. https://doi.org/10.1159/000530808Tourjman V., Kouassi É., Koué M.È., et al. Antipsychotics' effects on blood levels of cytokines in schizophrenia: a me-ta-analysis. Schizophrenia Research. 2013; 151(1-3): 43–47. https://doi.org/10.1016/j.schres.2013.10.011Tourjman V., Kouassi É., Koué M.È., et al. Antipsychotics' effects on blood levels of cytokines in schizophrenia: a me-ta-analysis. Schizophrenia Research. 2013; 151(1-3): 43–47. https://doi.org/10.1016/j.schres.2013.10.011Zhang Y., Ehrlich S.M., Zhu Q., Du S. Signaling mechanisms of the platelet glycoprotein Ib-IX complex. Platelets. 2022; 33(6): 823-832. https://doi.org/10.1080/09537104.2022.2071852Zhang Y., Ehrlich S.M., Zhu Q., Du S. Signaling mechanisms of the platelet glycoprotein Ib-IX complex. Platelets. 2022; 33(6): 823-832. https://doi.org/10.1080/09537104.2022.2071852Hajjiah A., Maadarani O., Bitar Z., et al. Antipsychotic drugs may contribute to venous thromboembolism – a case report and review of literature. JRSM Open. 2023; 14(1): 20542704221132142. https://doi.org/10.1177/20542704221132142Hajjiah A., Maadarani O., Bitar Z., et al. Antipsychotic drugs may contribute to venous thromboembolism – a case report and review of literature. JRSM Open. 2023; 14(1): 20542704221132142. https://doi.org/10.1177/20542704221132142National Center for Biotechnology Information (NCBI). Platelet-Activating Factor. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557392/National Center for Biotechnology Information (NCBI). Platelet-Activating Factor. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557392/Ollivier V., Syvannarath V., Gros A., et al. Collagen can selectively trigger a platelet secretory phenotype via glycoprotein VI. PloS One. 2014; 9(8): e104712. https://doi.org/10.1371/journal.pone.0104712Ollivier V., Syvannarath V., Gros A., et al. Collagen can selectively trigger a platelet secretory phenotype via glycoprotein VI. PloS One. 2014; 9(8): e104712. https://doi.org/10.1371/journal.pone.0104712Hering J., Amann B., Angelkort B., Rottmann M. Thrombin-antithrombin III-complex and prothrombin fragment F1+2 in arterial and venous blood of patients with peripheral arterial disease. Vasa. 2003; 32(4): 193-197. https://doi.org/10.1024/0301-1526.32.4.193Hering J., Amann B., Angelkort B., Rottmann M. Thrombin-antithrombin III-complex and prothrombin fragment F1+2 in arterial and venous blood of patients with peripheral arterial disease. Vasa. 2003; 32(4): 193-197. https://doi.org/10.1024/0301-1526.32.4.193Hemant G., Indranil B., Alireza R.R. Thrombomodulin: a multifunctional receptor modulating the endothelial quiescence. Journal of Thrombosis and Haemostasis. 2024; 22(4): 905-914. https://doi.org/10.1016/j.jtha.2024.01.006Hemant G., Indranil B., Alireza R.R. Thrombomodulin: a multifunctional receptor modulating the endothelial quiescence. Journal of Thrombosis and Haemostasis. 2024; 22(4): 905-914. https://doi.org/10.1016/j.jtha.2024.01.006Zaidi S.R.H., Rout P. Interpretation of blood clotting studies and values (PT, PTT, aPTT, INR, anti-factor Xa, D-dimer) [Up-dated 2025]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available at: https://www.ncbi.nlm.nih.gov/books/NBK604215/Zaidi S.R.H., Rout P. Interpretation of blood clotting studies and values (PT, PTT, aPTT, INR, anti-factor Xa, D-dimer) [Up-dated 2025]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available at: https://www.ncbi.nlm.nih.gov/books/NBK604215/Ishioka M., Yasui-Furukori N., Sugawara N., et al. Hyperprolactinemia during antipsychotics treatment increases the level of coagulation markers. Neuropsychiatr. Dis. Treat. 2015; 11:477-484. https://doi.org/10.2147/NDT.S75176Ishioka M., Yasui-Furukori N., Sugawara N., et al. Hyperprolactinemia during antipsychotics treatment increases the level of coagulation markers. Neuropsychiatr. Dis. Treat. 2015; 11:477-484. https://doi.org/10.2147/NDT.S75176Santoro R.C., Molinari A.C., Leotta M., Martini T. Isolated prolongation of activated partial thromboplastin time: not just bleeding risk. Medicina (Kaunas, Lithuania). 2023; 59(6):1169. https://doi.org/10.3390/medicina59061169Santoro R.C., Molinari A.C., Leotta M., Martini T. Isolated prolongation of activated partial thromboplastin time: not just bleeding risk. Medicina (Kaunas, Lithuania). 2023; 59(6):1169. https://doi.org/10.3390/medicina59061169Chornenki N.L.J., Fralick M., Sholzberg M. International normalized ratio and activated partial thromboplastin time testing. CMAJ:Canadian Medical Association journal. 2022; 194(33):E1135. https://doi.org/10.1503/cmaj.220629Chornenki N.L.J., Fralick M., Sholzberg M. International normalized ratio and activated partial thromboplastin time testing. CMAJ:Canadian Medical Association journal. 2022; 194(33):E1135. https://doi.org/10.1503/cmaj.220629Hsu E., Moosavi L. Biochemistry, Antithrombin III. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545295/Hsu E., Moosavi L. Biochemistry, Antithrombin III. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545295/Dorgalaleh A., Favaloro E.J., Bahraini M., Rad F. Standardization of Prothrombin Time/International Normalized Ratio (PT/INR). International Journal of Laboratory Hematology. 2021; 43(1):21–28. https://doi.org/10.1111/ijlh.13349Dorgalaleh A., Favaloro E.J., Bahraini M., Rad F. Standardization of Prothrombin Time/International Normalized Ratio (PT/INR). International Journal of Laboratory Hematology. 2021; 43(1):21–28. https://doi.org/10.1111/ijlh.13349Croquet V., Vuillemin E., Ternisien C., et al. Prothrombin index is an indirect marker of severe liver fibrosis. Eur. J. Gastro-enterol. Hepatol. 2002; 14(10): 1133-1141. https://doi.org/10.1097/00042737-200210000-00015Croquet V., Vuillemin E., Ternisien C., et al. Prothrombin index is an indirect marker of severe liver fibrosis. Eur. J. Gastro-enterol. Hepatol. 2002; 14(10): 1133-1141. https://doi.org/10.1097/00042737-200210000-00015Carrizo E., Fernández V., Quintero J., et al. Coagulation and inflammation markers during atypical or typical antipsychotic treatment in schizophrenia patients and drug-free first-degree relatives. Schizophrenia Research. 2008; 103(1-3): 83–93. https://doi.org/10.1016/j.schres.2008.03.004Carrizo E., Fernández V., Quintero J., et al. Coagulation and inflammation markers during atypical or typical antipsychotic treatment in schizophrenia patients and drug-free first-degree relatives. Schizophrenia Research. 2008; 103(1-3): 83–93. https://doi.org/10.1016/j.schres.2008.03.004Pinjari O.F., Dasgupta S.K., Okusaga O.O. Plasma soluble P-selectin, Interleukin-6 and S100B protein in patients with schizophrenia: a pilot study. Psychiatr. Q. 2022; 93(1): 335-345. https://doi.org/10.1007/s11126-021-09954-3Pinjari O.F., Dasgupta S.K., Okusaga O.O. Plasma soluble P-selectin, Interleukin-6 and S100B protein in patients with schizophrenia: a pilot study. Psychiatr. Q. 2022; 93(1): 335-345. https://doi.org/10.1007/s11126-021-09954-3Ma Y.Q., Xu Z., Zhu J. Integrin αIIbβ3. In: Gresele, P., López, J.A., Angiolillo, D.J., Page, C.P. (eds) Platelet Physiology I. Platelets in Thrombotic and Non-Thrombotic Disorders. Springer, Cham. 2025. doi: 10.1007/978-3-031-96340-7_12Ma Y.Q., Xu Z., Zhu J. Integrin αIIbβ3. In: Gresele, P., López, J.A., Angiolillo, D.J., Page, C.P. (eds) Platelet Physiology I. Platelets in Thrombotic and Non-Thrombotic Disorders. Springer, Cham. 2025. doi: 10.1007/978-3-031-96340-7_12Debaene C.B., Feys H.B.A.B., Six K.R.A. Shedding light on GPIbα shedding. Current Opinion in Hematology. 2024; 31(5):224-229. https://doi.org/10.1097/MOH.0000000000000826Debaene C.B., Feys H.B.A.B., Six K.R.A. Shedding light on GPIbα shedding. Current Opinion in Hematology. 2024; 31(5):224-229. https://doi.org/10.1097/MOH.0000000000000826Chawla D., Saad E., Khairi T., Padmanabhan A. Severe persistent heparin-induced thrombocytopenia in a renal transplant patient. Thrombosis Research. 2019; 183:106–107. https://doi.org/10.1016/j.thromres.2019.10.014Chawla D., Saad E., Khairi T., Padmanabhan A. Severe persistent heparin-induced thrombocytopenia in a renal transplant patient. Thrombosis Research. 2019; 183:106–107. https://doi.org/10.1016/j.thromres.2019.10.014Oruch R., Hodneland E., Pryme I.F., Holmsen H. Psychotropic drugs interfere with the tight coupling of polyphospho-inositide cycle metabolites in human platelets: a result of receptor-independent drug intercalation in the plasma membrane?. Biochimica et Biophysica Acta. 2008; 1778(10): 2165–2176. https://doi.org/10.1016/j.bbamem.2008.04.007Oruch R., Hodneland E., Pryme I.F., Holmsen H. Psychotropic drugs interfere with the tight coupling of polyphospho-inositide cycle metabolites in human platelets: a result of receptor-independent drug intercalation in the plasma membrane?. Biochimica et Biophysica Acta. 2008; 1778(10): 2165–2176. https://doi.org/10.1016/j.bbamem.2008.04.007Bertha B.G., Sill J.C., Berger I., et al. High-dose droperidol protects against experimental coronary thrombosis in dogs and pigs and attenuates aggregation of porcine platelets and Ca2+ mobilization in human platelets. Anesthesiology. 1993; 78(4):733–743. https://doi.org/10.1097/00000542-199304000-00017Bertha B.G., Sill J.C., Berger I., et al. High-dose droperidol protects against experimental coronary thrombosis in dogs and pigs and attenuates aggregation of porcine platelets and Ca2+ mobilization in human platelets. Anesthesiology. 1993; 78(4):733–743. https://doi.org/10.1097/00000542-199304000-00017Instructions for medical use of the drug - Haloperidol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%A1-000645/InstrImg_2021_05_26_1469341/ae771f5a-f866-47eb-84b0-40eec18a8908.pdfInstructions for medical use of the drug - Haloperidol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%A1-000645/InstrImg_2021_05_26_1469341/ae771f5a-f866-47eb-84b0-40eec18a8908.pdfInstructions for medical use of the drug - Droperidol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001100_-_%D0%A0%D0%93-RU_/InstrImg_2022_09_09_1486781/1fa961c9-e598-45c1-bf20-3e4593c1c915.pdfInstructions for medical use of the drug - Droperidol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001100_-_%D0%A0%D0%93-RU_/InstrImg_2022_09_09_1486781/1fa961c9-e598-45c1-bf20-3e4593c1c915.pdfInstructions for medical use of the drug - Zuclopenthixol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_011913_-_%D0%A0%D0%93-RU_/InstrImg_2026_02_02_1525913/f35eb14c-aac7-480e-a721-3372c5a54974.pdfInstructions for medical use of the drug - Zuclopenthixol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_011913_-_%D0%A0%D0%93-RU_/InstrImg_2026_02_02_1525913/f35eb14c-aac7-480e-a721-3372c5a54974.pdfInstructions for medical use of the drug - Tizercin. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_000079_-_%D0%A0%D0%93-RU_/InstrImg_2021_5_27_1469415/%D0%9B%D0%9F-%E2%84%96(000079)-(%D0%A0%D0%93-RU)[2020]_0.pdfInstructions for medical use of the drug - Tizercin. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_000079_-_%D0%A0%D0%93-RU_/InstrImg_2021_5_27_1469415/%D0%9B%D0%9F-%E2%84%96(000079)-(%D0%A0%D0%93-RU)[2020]_0.pdfSingh A.N., Barlas C., Saeedi H., Mishra R.K. Effect of loxapine on peripheral dopamine-like and serotonin receptors in patients with schizophrenia. Journal of Psychiatry & Neuroscience. 2003; 28(1), 39–47.Singh A.N., Barlas C., Saeedi H., Mishra R.K. Effect of loxapine on peripheral dopamine-like and serotonin receptors in patients with schizophrenia. Journal of Psychiatry & Neuroscience. 2003; 28(1), 39–47.Instructions for medical use of the drug - Periciazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_006400_-_%D0%A0%D0%93-RU_/InstrImg_2024_12_03_1511622/4d5ae6f6-4c61-4a1e-ac54-9b11b5f75fa7.pdfInstructions for medical use of the drug - Periciazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_006400_-_%D0%A0%D0%93-RU_/InstrImg_2024_12_03_1511622/4d5ae6f6-4c61-4a1e-ac54-9b11b5f75fa7.pdfSuzuki O., Seno H., Kumazawa T. In vitro inhibition of human platelet monoamine oxidase by phenothiazine derivatives. Life Sciences. 1988; 42(21): 2131–2136. https://doi.org/10.1016/0024-3205(88)90127-0Suzuki O., Seno H., Kumazawa T. In vitro inhibition of human platelet monoamine oxidase by phenothiazine derivatives. Life Sciences. 1988; 42(21): 2131–2136. https://doi.org/10.1016/0024-3205(88)90127-0Instructions for medical use of the drug - Perphenazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_012481_-_%D0%A0%D0%93-RU_/InstrImg_2025_12_22_1524535/f9bd41a0-8a03-4601-9c1c-55e39a0fd4b0.pdfInstructions for medical use of the drug - Perphenazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_012481_-_%D0%A0%D0%93-RU_/InstrImg_2025_12_22_1524535/f9bd41a0-8a03-4601-9c1c-55e39a0fd4b0.pdfMcfarland R.B. Fatal drug reaction associated with prochlorperazine (compazine). report of a case characterized by jaundice, thrombocytopenia, and agranulocytosis. American Journal of Clinical Pathology. 1963; 40:284–290. https://doi.org/10.1093/ajcp/40.3.284Mcfarland R.B. Fatal drug reaction associated with prochlorperazine (compazine). report of a case characterized by jaundice, thrombocytopenia, and agranulocytosis. American Journal of Clinical Pathology. 1963; 40:284–290. https://doi.org/10.1093/ajcp/40.3.284Instructions for medical use of the drug - Sulpiride. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_008846_-_%D0%A0%D0%93-RU_/InstrImg_2025_03_25_1515313/f930f6cd-1fec-4bbd-90ff-58f13153ac3f.pdfInstructions for medical use of the drug - Sulpiride. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_008846_-_%D0%A0%D0%93-RU_/InstrImg_2025_03_25_1515313/f930f6cd-1fec-4bbd-90ff-58f13153ac3f.pdfInstructions for medical use of the drug - Thioproperazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9F_N014904_01/InstrImg_2021_03_30_5409/ca8cddcb-52b5-4fa9-b5bf-7980b83c8eab.pdfInstructions for medical use of the drug - Thioproperazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9F_N014904_01/InstrImg_2021_03_30_5409/ca8cddcb-52b5-4fa9-b5bf-7980b83c8eab.pdfInstructions for medical use of the drug - Thioridazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_010434_-_%D0%A0%D0%93-RU_/InstrImg_2025_06_25_1518539/8e02b14b-28e4-4671-bc6b-77f36d2b7268.pdfInstructions for medical use of the drug - Thioridazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_010434_-_%D0%A0%D0%93-RU_/InstrImg_2025_06_25_1518539/8e02b14b-28e4-4671-bc6b-77f36d2b7268.pdfBalon R., Berchou R., Zethelius M. Thrombocytopenia associated with chlorpromazine, haloperidol and thiothixene: a case report. Canadian Journal of Psychiatry. 1987; 32(2):149–150. https://doi.org/10.1177/070674378703200213Balon R., Berchou R., Zethelius M. Thrombocytopenia associated with chlorpromazine, haloperidol and thiothixene: a case report. Canadian Journal of Psychiatry. 1987; 32(2):149–150. https://doi.org/10.1177/070674378703200213Holmsen H., Daniel J.L., Dangelmaier C.A., et al. Differential effects of trifluoperazine on arachidonate liberation, secretion and myosin phosphorylation in intact platelets. Thrombosis Research. 1984; 36(5), 419–428. https://doi.org/10.1016/0049-3848(84)90298-6Holmsen H., Daniel J.L., Dangelmaier C.A., et al. Differential effects of trifluoperazine on arachidonate liberation, secretion and myosin phosphorylation in intact platelets. Thrombosis Research. 1984; 36(5), 419–428. https://doi.org/10.1016/0049-3848(84)90298-6Instructions for medical use of the drug - Trifluoperazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9F_N015130_01/InstrImg_2023_06_19_1496225/ec94b864-40ea-4d0a-9936-5c6d71c60144.pdfInstructions for medical use of the drug - Trifluoperazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9F_N015130_01/InstrImg_2023_06_19_1496225/ec94b864-40ea-4d0a-9936-5c6d71c60144.pdfInstructions for medical use of the drug - Flupentixol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-005281/InstrImg_2021_12_20_1476543/d8f8ef36-89a0-41b5-9b0a-50efa003a0df.pdfInstructions for medical use of the drug - Flupentixol. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-005281/InstrImg_2021_12_20_1476543/d8f8ef36-89a0-41b5-9b0a-50efa003a0df.pdfHolt R.J. Neuroleptic drug-induced changes in platelet levels. Journal of ClinicalPpsychopharmacology. 1984; 4(3):130–132.Holt R.J. Neuroleptic drug-induced changes in platelet levels. Journal of ClinicalPpsychopharmacology. 1984; 4(3):130–132.Zubenko G.S., Cohen B.M. In vitro effects of psychotropic agents on the microviscosity of platelet membranes. Psychophar-macology. 1984; 84(2):289–292. https://doi.org/10.1007/BF00427463Zubenko G.S., Cohen B.M. In vitro effects of psychotropic agents on the microviscosity of platelet membranes. Psychophar-macology. 1984; 84(2):289–292. https://doi.org/10.1007/BF00427463Pandey S.C., Sharma R.P., Janicak P.G., Marks R.C., Davis J.M., Pandey G.N. Platelet serotonin-2 receptors in schizophrenia: effects of illness and neuroleptic treatment. Psychiatry Research. 1993; 48(1):57–68. doi: 10.1016/0165-1781(93)90113-uPandey S.C., Sharma R.P., Janicak P.G., Marks R.C., Davis J.M., Pandey G.N. Platelet serotonin-2 receptors in schizophrenia: effects of illness and neuroleptic treatment. Psychiatry Research. 1993; 48(1):57–68. doi: 10.1016/0165-1781(93)90113-uInstructions for medical use of the drug - Fluphenazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_004077_-_%D0%A0%D0%93-RU_/InstrImg_2024_01_24_1501346/fbc57572-788e-457b-b8c7-bdc20110bb79.pdfInstructions for medical use of the drug - Fluphenazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_004077_-_%D0%A0%D0%93-RU_/InstrImg_2024_01_24_1501346/fbc57572-788e-457b-b8c7-bdc20110bb79.pdfHolmsen H., Rygh, T. Chlorpromazine makes the platelet plasma membrane permeable for low-molecular weight substances and reduces ATP production. Biochemical Pharmacology. 1990; 40(2), 373–376. doi: 10.1016/0006-2952(90)90701-lHolmsen H., Rygh, T. Chlorpromazine makes the platelet plasma membrane permeable for low-molecular weight substances and reduces ATP production. Biochemical Pharmacology. 1990; 40(2), 373–376. doi: 10.1016/0006-2952(90)90701-lWarlow C., Ogston D., Douglas A.S. Platelet function after the administration of chlorpromazine to human subjects. Hae-mostasis. 1976; 5(1):21–26. https://doi.org/10.1159/000214115Warlow C., Ogston D., Douglas A.S. Platelet function after the administration of chlorpromazine to human subjects. Hae-mostasis. 1976; 5(1):21–26. https://doi.org/10.1159/000214115Instructions for medical use of the drug - chlorpromazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001706_-_%D0%A0%D0%93-RU_/InstrImg_2024_02_06_1501740/8e2be4ba-9a8e-41a2-9133-a7ebcb6e208d.pdfInstructions for medical use of the drug - chlorpromazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001706_-_%D0%A0%D0%93-RU_/InstrImg_2024_02_06_1501740/8e2be4ba-9a8e-41a2-9133-a7ebcb6e208d.pdfInstructions for medical use of the drug - chlorprothixene. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_000203_-_%D0%A0%D0%93-RU_/InstrImg_2021_4_28_1468593/%D0%9B%D0%9F-%E2%84%96(000203)-(%D0%A0%D0%93-RU)[2021]_0.pdfInstructions for medical use of the drug - chlorprothixene. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_000203_-_%D0%A0%D0%93-RU_/InstrImg_2021_4_28_1468593/%D0%9B%D0%9F-%E2%84%96(000203)-(%D0%A0%D0%93-RU)[2021]_0.pdfInstructions for medical use of the drug - asenapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-001526/InstrImg_2020_06_13_27412/f1b2224a-ca14-4da0-b4c2-b3cfbd23bdc2.pdfInstructions for medical use of the drug - asenapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-001526/InstrImg_2020_06_13_27412/f1b2224a-ca14-4da0-b4c2-b3cfbd23bdc2.pdfŞengül M.C., Kaya K., Yilmaz A., et al. Pulmonary thromboembolism due to paliperidone: report of 2 cases. The American Journal of Emergency Medicine. 2014; 32(7):814.e1–814.e8142. https://doi.org/10.1016/j.ajem.2013.12.038Şengül M.C., Kaya K., Yilmaz A., et al. Pulmonary thromboembolism due to paliperidone: report of 2 cases. The American Journal of Emergency Medicine. 2014; 32(7):814.e1–814.e8142. https://doi.org/10.1016/j.ajem.2013.12.038Instructions for medical use of the drug - amisulpride. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_012917_-_%D0%A0%D0%93-RU_/InstrImg_2025_12_30_1524945/42f0a04c-1f68-4390-ac3f-473ea03fe940.pdfInstructions for medical use of the drug - amisulpride. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_012917_-_%D0%A0%D0%93-RU_/InstrImg_2025_12_30_1524945/42f0a04c-1f68-4390-ac3f-473ea03fe940.pdfInstructions for medical use of the drug - ziprasidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_003752_-_%D0%A0%D0%93-RU_/InstrImg_2025_09_12_1521409/97c8fb2e-61ce-404a-bdcc-6ed21d19b357.pdfInstructions for medical use of the drug - ziprasidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_003752_-_%D0%A0%D0%93-RU_/InstrImg_2025_09_12_1521409/97c8fb2e-61ce-404a-bdcc-6ed21d19b357.pdfInstructions for medical use of the drug - Quetiapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_004607_-_%D0%A0%D0%93-RU_/InstrImg_2024_03_11_1502662/e70afdef-a62b-4995-9347-c8d8bd3bba08.pdfInstructions for medical use of the drug - Quetiapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_004607_-_%D0%A0%D0%93-RU_/InstrImg_2024_03_11_1502662/e70afdef-a62b-4995-9347-c8d8bd3bba08.pdfGligorijević N., Vasović T., Lević S., et al. Atypical antipsychotic clozapine binds fibrinogen and affects fibrin formation. International Journal of Biological Macromolecules. 2020; 154:142-149. https://doi.org/10.1016/j.ijbiomac.2020.03.119Gligorijević N., Vasović T., Lević S., et al. Atypical antipsychotic clozapine binds fibrinogen and affects fibrin formation. International Journal of Biological Macromolecules. 2020; 154:142-149. https://doi.org/10.1016/j.ijbiomac.2020.03.119Instructions for medical use of the drug - clozapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_011446_-_%D0%A0%D0%93-RU_/InstrImg_2025_09_16_1521486/b0d83477-5a93-4dc1-b590-027829ea9a62.pdfInstructions for medical use of the drug - clozapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_011446_-_%D0%A0%D0%93-RU_/InstrImg_2025_09_16_1521486/b0d83477-5a93-4dc1-b590-027829ea9a62.pdfRafi M., Goyal C., Reddy P., Reddy S. Lurasidone induced thrombocytopenia: is it a signal of drug induced myelosuppres-sion? Indian Journal of Psychological Medicine. 2018; 40(2): 191–192. https://doi.org/10.4103/IJPSYM.IJPSYM_374_17Rafi M., Goyal C., Reddy P., Reddy S. Lurasidone induced thrombocytopenia: is it a signal of drug induced myelosuppres-sion? Indian Journal of Psychological Medicine. 2018; 40(2): 191–192. https://doi.org/10.4103/IJPSYM.IJPSYM_374_17Instructions for medical use of the drug - Lurasidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_011432_-_%D0%A0%D0%93-RU_/InstrImg_2025_09_04_1520983/728d4b45-574d-4ed3-99e3-6c687fbbc3b2.pdfInstructions for medical use of the drug - Lurasidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_011432_-_%D0%A0%D0%93-RU_/InstrImg_2025_09_04_1520983/728d4b45-574d-4ed3-99e3-6c687fbbc3b2.pdfBokhari S.A., Butaher H., Saleem R., Elhassan N. Olanzapine-induced thrombocytopenia in a patient with chronic schizo-phrenia: a case report. Cureus. 2024; 16(11):e74677. https://doi.org/10.7759/cureus.74677Bokhari S.A., Butaher H., Saleem R., Elhassan N. Olanzapine-induced thrombocytopenia in a patient with chronic schizo-phrenia: a case report. Cureus. 2024; 16(11):e74677. https://doi.org/10.7759/cureus.74677Rasras H., Beghi M., Samti M., et al. Rare and underestimated association of pulmonary embolism and olanzapine therapy; report of two cases. Archives of Academic Emergency Medicine. 2021; 9(1):e17. https://doi.org/10.22037/aaem.v9i1.1063Rasras H., Beghi M., Samti M., et al. Rare and underestimated association of pulmonary embolism and olanzapine therapy; report of two cases. Archives of Academic Emergency Medicine. 2021; 9(1):e17. https://doi.org/10.22037/aaem.v9i1.1063Maazouzi M., Bouallala A., Haddadi Z., et al. Antipsychotic drugs as a contributing factor of pulmonary embolism: a report of 4 cases. Radiology Case Reports. 2023; 18(5):1997-2000. https://doi.org/10.1016/j.radcr.2023.02.046Maazouzi M., Bouallala A., Haddadi Z., et al. Antipsychotic drugs as a contributing factor of pulmonary embolism: a report of 4 cases. Radiology Case Reports. 2023; 18(5):1997-2000. https://doi.org/10.1016/j.radcr.2023.02.046Instructions for medical use of the drug - Olanzapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_002284_-_%D0%A0%D0%93-RU_/InstrImg_2023_05_15_1493505/35008e88-73eb-46b5-ac42-93f59f0ecc5d.pdfInstructions for medical use of the drug - Olanzapine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_002284_-_%D0%A0%D0%93-RU_/InstrImg_2023_05_15_1493505/35008e88-73eb-46b5-ac42-93f59f0ecc5d.pdfLin Y.C., Chen C.W., Chen B.L., Kao Y.T., Huang C.Y. A Case report of chronic thromboembolic pulmonary hypertension after long-term use of risperidone and paliperidone. Acta Cardiologica Sinica. 2020; 36(5):514–516. https://doi.org/10.6515/ACS.202009_36(5).20200526ALin Y.C., Chen C.W., Chen B.L., Kao Y.T., Huang C.Y. A Case report of chronic thromboembolic pulmonary hypertension after long-term use of risperidone and paliperidone. Acta Cardiologica Sinica. 2020; 36(5):514–516. https://doi.org/10.6515/ACS.202009_36(5).20200526AYılmaz E.D., Motor S., Sefil, F., et al. Effects of paliperidone palmitate on coagulation: an experimental study. TheScientific-WorldJournal. 2014; 964380. https://doi.org/10.1155/2014/964380Yılmaz E.D., Motor S., Sefil, F., et al. Effects of paliperidone palmitate on coagulation: an experimental study. TheScientific-WorldJournal. 2014; 964380. https://doi.org/10.1155/2014/964380Zhang X.R., Zhang Z.J., Jenkins T.A., et al. The effect of chronic antipsychotic drug administration on nitric oxide synthase activity and gene expression in rat penile tissues. European Neuropsychopharmacology. 2010; 20(4):211-217, https://doi.org/10.1016/j.euroneuro.2009.10.002.Zhang X.R., Zhang Z.J., Jenkins T.A., et al. The effect of chronic antipsychotic drug administration on nitric oxide synthase activity and gene expression in rat penile tissues. European Neuropsychopharmacology. 2010; 20(4):211-217, https://doi.org/10.1016/j.euroneuro.2009.10.002.Instructions for medical use of the drug - Paliperidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_003795_-_%D0%A0%D0%93-RU_/InstrImg_2025_05_19_1517377/c29bba5d-e730-4ae9-b3c8-2569c8a4299d.pdfInstructions for medical use of the drug - Paliperidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_003795_-_%D0%A0%D0%93-RU_/InstrImg_2025_05_19_1517377/c29bba5d-e730-4ae9-b3c8-2569c8a4299d.pdfSaxena S.K., Dwivedi A.K., Timothy A., et al. Risperidone-induced thrombocytopenia in a case of psychosis and neuroen-docrine tumor: a case report. Indian Journal of Psychiatry. 2021; 63(3):311–312. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_488_20Saxena S.K., Dwivedi A.K., Timothy A., et al. Risperidone-induced thrombocytopenia in a case of psychosis and neuroen-docrine tumor: a case report. Indian Journal of Psychiatry. 2021; 63(3):311–312. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_488_20Instructions for medical use of the drug - Risperidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_007087_-_%D0%A0%D0%93-RU_/InstrImg_2024_10_18_1509888/a5b2e6b5-3566-42d6-83d1-c829ad85f179.pdfInstructions for medical use of the drug - Risperidone. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_007087_-_%D0%A0%D0%93-RU_/InstrImg_2024_10_18_1509888/a5b2e6b5-3566-42d6-83d1-c829ad85f179.pdfInstructions for medical use of the drug - Sertindole. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%A1-000615/InstrImg_2024_04_17_1503727/2fcd58d6-5f65-474d-b196-e6a9d51aceeb.pdfInstructions for medical use of the drug - Sertindole. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%A1-000615/InstrImg_2024_04_17_1503727/2fcd58d6-5f65-474d-b196-e6a9d51aceeb.pdfInstructions for medical use of the drug - Aripiprazole. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001283_-_%D0%A0%D0%93-RU_/InstrImg_2022_11_17_1488952/77228122-3caa-4a97-ac83-016331734041.pdfInstructions for medical use of the drug - Aripiprazole. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001283_-_%D0%A0%D0%93-RU_/InstrImg_2022_11_17_1488952/77228122-3caa-4a97-ac83-016331734041.pdfInstructions for medical use of the drug - Brexipiprazole. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-006867/InstrImg_2022_12_05_1489336/525fdef5-8b68-4991-adb6-7816c5604c1a.pdfInstructions for medical use of the drug - Brexipiprazole. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-006867/InstrImg_2022_12_05_1489336/525fdef5-8b68-4991-adb6-7816c5604c1a.pdfInstructions for medical use of the drug - Cariprazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001510_-_%D0%A0%D0%93-RU_/InstrImg_2025_04_14_1516155/f8733f55-8c23-4502-8e68-f40b402395b7.pdfInstructions for medical use of the drug - Cariprazine. Available at: https://cdn.pharm-portal.ru/69jxs7cjr4n4gdc2acy5y4x8/instructions/%D0%9B%D0%9F-_N_001510_-_%D0%A0%D0%93-RU_/InstrImg_2025_04_14_1516155/f8733f55-8c23-4502-8e68-f40b402395b7.pdfChen T.Y., Lin C.E., Chen L.F., Tzeng N.S. Enhanced bleeding risk in an elderly dementia patient treated with warfarin and quetiapine. The Journal of neuropsychiatry and clinical neurosciences. 2013; 25(4): E25. https://doi.org/10.1176/appi.neuropsych.12090232Chen T.Y., Lin C.E., Chen L.F., Tzeng N.S. Enhanced bleeding risk in an elderly dementia patient treated with warfarin and quetiapine. The Journal of neuropsychiatry and clinical neurosciences. 2013; 25(4): E25. https://doi.org/10.1176/appi.neuropsych.12090232Saracoglu H., Karakukcu C., Kilic C., Simsek Y. Potential indicators of bone marrow suppression in patients with schizo-phrenia receiving clozapine: platelet-large cell ratio and immature granulocytes. Psychiatry and Behavioral Sciences. 2024; 14(4): 123-130. https://doi.org/10.5455/PBS.20240301055535Saracoglu H., Karakukcu C., Kilic C., Simsek Y. Potential indicators of bone marrow suppression in patients with schizo-phrenia receiving clozapine: platelet-large cell ratio and immature granulocytes. Psychiatry and Behavioral Sciences. 2024; 14(4): 123-130. https://doi.org/10.5455/PBS.20240301055535Yan P., Gao B., Wang S., et al. Association of 5-HTR2A T102C and A-1438G polymorphisms with clinical response to atypical antipsychotic treatment in schizophrenia: a meta-analysis. Neuroscience Letters. 2022; 770:136395. https://doi.org/10.1016/j.neulet.2021.136395Yan P., Gao B., Wang S., et al. Association of 5-HTR2A T102C and A-1438G polymorphisms with clinical response to atypical antipsychotic treatment in schizophrenia: a meta-analysis. Neuroscience Letters. 2022; 770:136395. https://doi.org/10.1016/j.neulet.2021.136395ClinicalTrials.gov. Pharmacogenetics and Therapeutic Drug Monitoring In Schizophrenia (PROMISE). Identifier: NCT05839613. Available at: https://clinicaltrials.gov/study/NCT05839613?tab=studyClinicalTrials.gov. Pharmacogenetics and Therapeutic Drug Monitoring In Schizophrenia (PROMISE). Identifier: NCT05839613. Available at: https://clinicaltrials.gov/study/NCT05839613?tab=studyIvashchenko D.V., Yudelevich D.A., Buromskaya N.I., et al. CYP2D6 phenotype and ABCB1 haplotypes are associated with antipsychotic safety in adolescents experiencing acute psychotic episodes. Drug Metabolism and Personalized Therapy. 2021; 37(1), 47–53. https://doi.org/10.1515/dmpt-2021-0124Ivashchenko D.V., Yudelevich D.A., Buromskaya N.I., et al. CYP2D6 phenotype and ABCB1 haplotypes are associated with antipsychotic safety in adolescents experiencing acute psychotic episodes. Drug Metabolism and Personalized Therapy. 2021; 37(1), 47–53. https://doi.org/10.1515/dmpt-2021-0124Singh R., Bansal Y., Medhi B., Kuhad A. Antipsychotics-induced metabolic alterations: Recounting the mechanistic insights, therapeutic targets and pharmacological alternatives. European Journal of Pharmacology. 2019; 844: 231–240. https://doi.org/10.1016/j.ejphar.2018.12.003Singh R., Bansal Y., Medhi B., Kuhad A. Antipsychotics-induced metabolic alterations: Recounting the mechanistic insights, therapeutic targets and pharmacological alternatives. European Journal of Pharmacology. 2019; 844: 231–240. https://doi.org/10.1016/j.ejphar.2018.12.003Josefsson E., Vainchenker W., Chloe J. Regulation of platelet production and life span: role of bcl-xl and potential implications for human platelet diseases. International Journal of Molecular Sciences. 2020; 21: 1-12. https://doi.org/10.3390/ijms21207591Josefsson E., Vainchenker W., Chloe J. Regulation of platelet production and life span: role of bcl-xl and potential implications for human platelet diseases. International Journal of Molecular Sciences. 2020; 21: 1-12. https://doi.org/10.3390/ijms21207591Badawy A.Z., Kandel S.H., Ahmedy I.A., et al. Evaluation of Bak and Bcl-Xl gene expression among pediatric patients with acute primary immune thrombocytopenia. Clinical and Experimental Pediatrics. 2025; 68(11):901–908. doi: 10.3345/cep.2025.00997Badawy A.Z., Kandel S.H., Ahmedy I.A., et al. Evaluation of Bak and Bcl-Xl gene expression among pediatric patients with acute primary immune thrombocytopenia. Clinical and Experimental Pediatrics. 2025; 68(11):901–908. doi: 10.3345/cep.2025.00997Lindquist I., Olson S.R., Li A., et al. The efficacy and safety of thrombopoietin receptor agonists in patients with chronic liver disease undergoing elective procedures: a systematic review and meta-analysis. Platelets. 2022; 33(1): 66–72. doi: 10.1080/09537104.2020.1859102Lindquist I., Olson S.R., Li A., et al. The efficacy and safety of thrombopoietin receptor agonists in patients with chronic liver disease undergoing elective procedures: a systematic review and meta-analysis. Platelets. 2022; 33(1): 66–72. doi: 10.1080/09537104.2020.1859102Wu X., Liu Y., Zou C., et al. Nicotine's impact on platelet function: insights into hemostasis mechanisms. Frontiers in Phar-macology. 2025; 15: 1512142. https://doi.org/10.3389/fphar.2024.1512142Wu X., Liu Y., Zou C., et al. Nicotine's impact on platelet function: insights into hemostasis mechanisms. Frontiers in Phar-macology. 2025; 15: 1512142. https://doi.org/10.3389/fphar.2024.1512142Hsu W.Y., Lane H.Y., Lin C.L., Kao C.H. A population-based cohort study on deep vein thrombosis and pulmonary embo-lism among schizophrenia patients. Schizophrenia Research. 2015; 162(1–3): 248-252. https://doi.org/10.1016/j.schres.2015.01.012Hsu W.Y., Lane H.Y., Lin C.L., Kao C.H. A population-based cohort study on deep vein thrombosis and pulmonary embo-lism among schizophrenia patients. Schizophrenia Research. 2015; 162(1–3): 248-252. https://doi.org/10.1016/j.schres.2015.01.012Kaiser R., Anjum A., Nicolai L. Platelet heterogeneity in disease: the many and the diverse? Blood. 2025; 146(24):2870–2881. https://doi.org/10.1182/blood.2025028957Kaiser R., Anjum A., Nicolai L. Platelet heterogeneity in disease: the many and the diverse? Blood. 2025; 146(24):2870–2881. https://doi.org/10.1182/blood.2025028957SCORE (Systematic Coronary Risk Evaluation) scale. Available at: https://zdrav-nnov.ru/grazhdanam/kalkulyator-zdorovya/shkala-score/SCORE (Systematic Coronary Risk Evaluation) scale. Available at: https://zdrav-nnov.ru/grazhdanam/kalkulyator-zdorovya/shkala-score/Wells Scale for Pulmonary Embolism Probability [Internet]. MSD Manual Professional Edition. Available at: https://www.msdmanuals.com/ru/professional/multimedia/clinical-calculator/Wells Scale for Pulmonary Embolism Probability [Internet]. MSD Manual Professional Edition. Available at: https://www.msdmanuals.com/ru/professional/multimedia/clinical-calculator/Buryachkovskaya L.I., Lomakin N.V., Sumarokov A.B., Shirokov E.A. Efficacy and safety of antithrombotic therapy [venous thrombosis and pulmonary embolism]: scales and algorithms. Therapy Journal. 2018. Available at: https://therapy-journal.ru/articles/Effektivnost-i-bezopasnost-antitromboticheskoi-terapii-venoznyi-tromboz-i-tromboemboliya-legochnoi-arterii-shkaly-i-algoritmy.htmlBuryachkovskaya L.I., Lomakin N.V., Sumarokov A.B., Shirokov E.A. Efficacy and safety of antithrombotic therapy [venous thrombosis and pulmonary embolism]: scales and algorithms. Therapy Journal. 2018. Available at: https://therapy-journal.ru/articles/Effektivnost-i-bezopasnost-antitromboticheskoi-terapii-venoznyi-tromboz-i-tromboemboliya-legochnoi-arterii-shkaly-i-algoritmy.htmlWilkinson K.S., Sparks A.D., Gergi M., et al. Validation of the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) risk scores for venous thromboembolism and bleeding in an independent population. Re-search and Practice in Thrombosis and Haemostasis. 2024; 8(4):102441. https://doi.org/10.1016/j.rpth.2024.102441Wilkinson K.S., Sparks A.D., Gergi M., et al. Validation of the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) risk scores for venous thromboembolism and bleeding in an independent population. Re-search and Practice in Thrombosis and Haemostasis. 2024; 8(4):102441. https://doi.org/10.1016/j.rpth.2024.102441Clinical guidelines "Deep vein thrombosis" (Russian Federation, 2025). Available at: https://diseases.medelement.com/disease/Clinical guidelines "Deep vein thrombosis" (Russian Federation, 2025). Available at: https://diseases.medelement.com/disease/National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Published: November 27, 2017. Available at: https://dctd.cancer.gov/research/ctep-trials/for-sites/adverse-events/ctcae-v5-5x7.pdfNational Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Published: November 27, 2017. Available at: https://dctd.cancer.gov/research/ctep-trials/for-sites/adverse-events/ctcae-v5-5x7.pdfBassand J.P. GUSTO (Global Utilization of Streptokinase and Tissue plasminogen activator in Occluded arteries): logic wins at last. European Heart Journal. 1994; 15(1):2–4. doi: 10.1093/oxfordjournals.eurheartj.a060374Bassand J.P. GUSTO (Global Utilization of Streptokinase and Tissue plasminogen activator in Occluded arteries): logic wins at last. European Heart Journal. 1994; 15(1):2–4. doi: 10.1093/oxfordjournals.eurheartj.a060374Sobieraj D.M., White C.M., Kluger J., et al. Table 1, Thrombolysis in myocardial infarction (TIMI) Flow Grading System. In: Adjunctive Devices for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011. (Comparative Effectiveness Reviews, No. 42). Available at: https://www.ncbi.nlm.nih.gov/books/NBK84280/table/introduction.t1/Sobieraj D.M., White C.M., Kluger J., et al. Table 1, Thrombolysis in myocardial infarction (TIMI) Flow Grading System. In: Adjunctive Devices for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011. (Comparative Effectiveness Reviews, No. 42). Available at: https://www.ncbi.nlm.nih.gov/books/NBK84280/table/introduction.t1/Lip G.Y., Frison L., Halperin J.L., Lane D.A. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. Journal of the American College of Cardiology. 2011; 57(2): 173–180. https://doi.org/10.1016/j.jacc.2010.09.024Lip G.Y., Frison L., Halperin J.L., Lane D.A. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. Journal of the American College of Cardiology. 2011; 57(2): 173–180. https://doi.org/10.1016/j.jacc.2010.09.024Zhu W., Fu L., Ding Y., et al. Meta-analysis of ATRIA versus CHA2DS2-VASc for predicting stroke and thromboembolism in patients with atrial fibrillation. International Journal of Cardiology. 2017; 227: 436–442. https://doi.org/10.1016/j.ijcard.2016.11.015Zhu W., Fu L., Ding Y., et al. Meta-analysis of ATRIA versus CHA2DS2-VASc for predicting stroke and thromboembolism in patients with atrial fibrillation. International Journal of Cardiology. 2017; 227: 436–442. https://doi.org/10.1016/j.ijcard.2016.11.015Silverio A., Di Maio M., Buccheri S., et al. Validation of the academic research consortium high bleeding risk criteria in pa-tients undergoing percutaneous coronary intervention: A systematic review and meta-analysis of 10 studies and 67,862 pa-tients. International Journal of Cardiology. 2022; 347: 8–15. doi: 10.1016/j.ijcard.2021.11.015Silverio A., Di Maio M., Buccheri S., et al. Validation of the academic research consortium high bleeding risk criteria in pa-tients undergoing percutaneous coronary intervention: A systematic review and meta-analysis of 10 studies and 67,862 pa-tients. International Journal of Cardiology. 2022; 347: 8–15. doi: 10.1016/j.ijcard.2021.11.015IMPROVE Bleeding Risk Assessment Score [Internet]. Practical-Haemostasis.com. Available at: https://practical-haemostasis.com/Clinical%20Prediction%20Scores/Formulae%20code%20and%20formulae/Formulae/Bleeding-Risk-Assessment-Score/Improve_bleeding_risk_assessment_score.htmlIMPROVE Bleeding Risk Assessment Score [Internet]. Practical-Haemostasis.com. Available at: https://practical-haemostasis.com/Clinical%20Prediction%20Scores/Formulae%20code%20and%20formulae/Formulae/Bleeding-Risk-Assessment-Score/Improve_bleeding_risk_assessment_score.htmlZornberg G. L., Jick H. Antipsychotic drug use and risk of first-time idiopathic venous thromboembolism: a case-control study. Lancet (London, England). 2000; 356(9237): 1219–1223. https://doi.org/10.1016/S0140-6736(00)02784-7Zornberg G. L., Jick H. Antipsychotic drug use and risk of first-time idiopathic venous thromboembolism: a case-control study. Lancet (London, England). 2000; 356(9237): 1219–1223. https://doi.org/10.1016/S0140-6736(00)02784-7Semiz M., Yücel H., Kavakçı O., et al. Atypical antipsychotic use is an independent predictor for the increased mean platelet volume in patients with schizophrenia: a preliminary study. Journal of Research in Medical Sciences. 2013; 18(7): 561–566.Semiz M., Yücel H., Kavakçı O., et al. Atypical antipsychotic use is an independent predictor for the increased mean platelet volume in patients with schizophrenia: a preliminary study. Journal of Research in Medical Sciences. 2013; 18(7): 561–566.Carrizo E., Fernández V., Quintero J., et al. Coagulation and inflammation markers during atypical or typical antipsychotic treatment in schizophrenia patients and drug-free first-degree relatives. Schizophrenia Research. 2008; 1031(3): 83-93. https://doi.org/10.1016/j.schres.2008.03.004Carrizo E., Fernández V., Quintero J., et al. Coagulation and inflammation markers during atypical or typical antipsychotic treatment in schizophrenia patients and drug-free first-degree relatives. Schizophrenia Research. 2008; 1031(3): 83-93. https://doi.org/10.1016/j.schres.2008.03.004Koller D., Almenara S., Mejía G., et al. Metabolic effects of aripiprazole and olanzapine multiple-dose treatment in a ran-domised crossover clinical trial in healthy volunteers: association with pharmacogenetics. Advances in Therapy. 2021; 38(2): 1035–1054. https://doi.org/10.1007/s12325-020-01566-wKoller D., Almenara S., Mejía G., et al. Metabolic effects of aripiprazole and olanzapine multiple-dose treatment in a ran-domised crossover clinical trial in healthy volunteers: association with pharmacogenetics. Advances in Therapy. 2021; 38(2): 1035–1054. https://doi.org/10.1007/s12325-020-01566-wObukohwo O.M., Ben-Azu B., Nwangwa E.K., et al. Adverse hematological profiles associated with chlorpromazine anti-psychotic treatment in male rats: preventive and reversal mechanisms of taurine and coenzyme-Q10. Toxicology Reports. 2024; 12:448-462. https://doi.org/10.1016/j.toxrep.2024.04.004Obukohwo O.M., Ben-Azu B., Nwangwa E.K., et al. Adverse hematological profiles associated with chlorpromazine anti-psychotic treatment in male rats: preventive and reversal mechanisms of taurine and coenzyme-Q10. Toxicology Reports. 2024; 12:448-462. https://doi.org/10.1016/j.toxrep.2024.04.004

The authors declare that there are no conflicts of interest present.