OBJECTIVES: The risk of venous thromboembolism (VTE) associated with antipsychotic use has been examined in a variety of populations but not in postmenopausal women prone to VTE. This study aimed to assess the VTE risk related to antipsychotics after menopause. METHODS: A nested case-control study of 271,198 women aged ≧ 50 years was conducted analyzing data from the Taiwan Longitudinal Health Insurance Database during 2000-2008. VTE cases were identified based on the disease diagnosis coding and anticoagulant prescription or surgical thrombectomy procedure from the claims of inpatient or emergency care. Using risk set sampling, ten controls were selected for each case, matched on age (± 5 years), entry date (± 180 days), cancer diagnosis and major surgery procedure. Use of antipsychotics classified into typical antipsychotics (TAPs) and atypical antipsychotics (AAPs) was evaluated in the 365 days prior to an index date. Confounding was adjusted using a summary risk score for VTE during conditional multiple logistic regressions. RESULTS: A total of 1,616 VTE cases and 16,026 controls were identified. Any use of TAPs was associated with a 1.26-fold (95% CI, 1.06-1.50) increased VTE risk compared with nonuse. The risk varied depending on specific TAP-use scenarios, with the greatest risk being observed for parenteral administration (OR_adj, 1.82; 95% CI, 1.14-2.91), followed by high-average-daily dose (> 5 mg of olanzapine-equivalent dose; OR_adj, 1.75; 95% CI, 1.23-2.50), long-term use (> 30 days; OR_adj, 1.59; 95% CI, 1.17-2.17), and current use of TAPs (OR_adj, 1.54; 95% CI, 1.15-2.07). Conversely, the insignificant association between AAP use and VTE risk was found and remained across the abovementioned drug-use conditions. CONCLUSIONS: Use of TAPs but not AAPs is associated with an increased VTE risk. Healthcare professionals should be vigilant about VTE development in postmenopausal women receiving TAPs, especially for those receiving parenteral administration or high doses of TAPs.