Resolution of Ecchymotic Lesions due to Fluoxetine and Escitalopram after Introduction of Reboxetine
Abstract
Antidepressants, frequently prescribed in depression and anxiety disorders, are known to be risk factors for an increase in bleeding. Yet, unfavourable effects of selective serotonin reuptake inhibitör (SSRI) treatment on hemostasis have rarely been reported. The most frequently reported side effects of SSRIs on the hematologic system are prolonged bleeding time, impaired thrombocyte aggregation and activity. Here we present a case in whom ecchymotic lesions occurred with esscitalopram and fluoxetine and resolved with reboxetine.
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References
- Halperin D, Reber G. Influence of antidepressants on hemostasis. Dialogues Clin Neurosci 2007;9:47–59.
- Lemberger L, Bergstrom RF, Wolen RL, Farid NA, Enas GG, Aronoff GR. Fluoxetine: clinical pharmacology and physiologic disposition. J Clin Psychiatry 1985;46:14–9.
- Lam RW, Kennedy SH, Grigoriadis S, McIntyre RS, Milev R, Ramasubbu R, Parikh SV, Patten SB, Ravindran AV; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. III. Pharmacotherapy. J Affect Disord. 2009;117:26-43.
- Maurer-Spurej E, Pittendreigh C, Solomons K. The influence of selective serotonin reuptake inhibitors on human platelet serotonin. Thromb Haemost. 2004;91:119–28.
- Bakish D, Cavazzoni P, Chudzik J, Ravindran A Hrdina PD. Effects of selective serotonin reuptake inhibitors on platelet serotonin parameters in major depressive disorder. Biol Psychiatry. 1997;41:184– 90.
- Maurer-Spurej E. Serotonin reuptake inhibitors and cardiovascular diseases: a platelet connection. Cell Mol Life Sci. 2005;62:159–70.
- Sarma A, Horne MK 3rd. Venlafaxine-induced ecchymoses and impaired platelet aggregation. Eur J Haematol. 2006;77:533–7.
- Serebruany VL, Gurbel PA, O’Connor CM. Platelet inhibition by sertraline and N-desmethylsertraline: a possible missing link between depression, coronary events, and mortality benefits of selective serotonin reuptake inhibitors. Pharmacol Res. 2001;43:453–62.
- Hallbäck I, Hägg S, Eriksson AC, Whiss PA. In vitro effects of serotonin and noradrenaline reuptake inhibitors on human platelet adhesion and coagulation. Pharmacol Rep. 2012;64:979-83.
- Tharmapathy P, Selheim F, Odegaard K, Lund A, Holmsen H. Venlafaxine treatment stimulates blood platelet activity. J Clin Psychopharmacol. 2000;20:589–90.
