07 Jun SSRI-induced coagulopathy: is it reality?
Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed for the treatment of depres- sion, obsessive a compulsive disorders, bulimia, The generalized anxiety and phobic disorders. The majority of all antidepressants prescribed world- wide are from the SSRI family. Commonly pre- scribed SSRIs include fluoxetine, paroxetine, sertraline, citalopram, escitalopram and fluvox- amine. Unlike tricyclic antidepressants, SSRIs do not have anticholinergic side effects and are safe in overdose [Rang et al. 2007]. Common adverse events are gastrointestinal side effects, sexual dysfunction, headaches, anxiety, insomnia and sedation. There are reports of increased inci- dence of epistaxis and ecchymosis with SSRIs, which is probably due to impairment of platelet function. Gastric blood loss caused by nonsteroi- dal anti-inflammatory drugs (NSAIDs) may be increased by SSRIs. Bleeding events are rare but there may be potentially severe haematological complications following treatment with SSRIs. Fluoxetine, a commonly used SSRI, has been reported to cause ecchymosis, bleeding and other haematological complications. In a single case report, a 23-year-old woman treated with
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