SSRI-induced coagulopathy: is it reality?

Siddiqui, Riyaz Ahmed; Gawande, Sushil; Shende, Tanaji R.; Tadke, Rahul; Bhave, Sudhir; Kirpekar, Vivek

doi:10.1177/2045125311423781

Cited by 12 publications

(5 citation statements)

References 18 publications

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“…One concern could be increased risk of bleeding with OAT in this population, 43 possibly related to increased alcohol use, 44 , 45 , 46 poorer anticoagulation control for patients receiving a vitamin K antagonist, 43 and greater likelihood of receiving antidepressants with anticoagulant effects. 47 , 48 , 49 Alcohol abuse was more common among patients with bipolar disorder or schizophrenia vs the matched reference groups, and although the fully adjusted models accounted for this factor, we cannot discern the potential relevance of alcohol use below the diagnosis threshold.…”

Section: Discussionmentioning

confidence: 99%

Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation

et al. 2021

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IMPORTANCE Individuals with bipolar disorder or schizophrenia have a higher risk of adverse outcomes from cardiovascular diseases. Oral anticoagulation therapy (OAT) for patients with atrial fibrillation (AF) is needed for stroke prevention, but whether patients with bipolar disorder or schizophrenia face disparities in receiving this therapy is unknown.OBJECTIVE To assess whether bipolar disorder or schizophrenia is associated with a lower rate of OAT initiation in patients with incident AF and lower prevalence of OAT in those with prevalent AF.

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Section: Discussionmentioning

confidence: 99%

Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation

et al. 2021

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“…5 ). As SSRI antidepressants may collaterally perturb extrinsic pathway factors 46 47 , changes in extrinsic pathway proteins may be associated with the increased risk of suicidal behavior observed in depressed patients during the first month of SSRI therapy 48 . As an interesting tangent for future investigation, our previously published metabolomic findings have also shown that suicide attempters occupy a phenotypic “middle ground” with respect to plasma levels of alanine, glycine, and glucose 16 .…”

Section: Discussionmentioning

confidence: 99%

The Extrinsic Coagulation Pathway: a Biomarker for Suicidal Behavior in Major Depressive Disorder

Yang

Chen

Liu

et al. 2016

Sci Rep

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Although an association between major depressive disorder (MDD) and suicide exists, most depressed patients never attempt suicide. An improved understanding of the factors contributing to suicidal risk in MDD can provide direction for suicide predictor development. In MDD suicide attempters (MDD-SA), MDD non-attempters (MDD-NA), and healthy controls (HC) (n = 12 each group), complementary plasma proteomics identified 45 differential proteins mapped to coagulation and inflammation, 25 of which underwent Western blotting. In another cohort including antidepressant-treated patients (n = 49 each group), seven additional extrinsic pathway proteins were selected for ELISA. Two inflammatory proteins and eight coagulatory proteins demonstrated alterations in MDD-SA relative to MDD-NA and HC. Applying a relative mass-action ratio, MDD-SA subjects displayed a higher relative prothrombinase activity than MDD-NA subjects, while healthy controls displayed higher relative prothrombinase activity than both MDD-SA and MDD-NA subjects. Consistent with our human findings, we found that heparin treatment significantly increased forced swimming test (FST) immobility time in rodents. MDD, independent of suicidality, is associated with a proinflammatory state accompanied by a hypothrombotic state. Suicidal behavior in MDD is associated with a more pronounced proinflammatory and prothrombotic phenotype accompanied by extrinsic pathway activation, revealing an extrinsic pathway biomarker that can be applied in predicting and monitoring suicidal risk.

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“…ve fluoksetinin hemotolojik parametreler üzerine etkisinin karşılaştırıldığı bir izlem çalışmasında 3. ayın sonunda fluoksetin kullanan hastalarda kanama zamanının başlangıç dönemine göre uzadığı ancak normal sınırlarda kaldığı belirlenmiş, bu durum; koagülopatilerin SSGİ kullanımı için kontrendikasyon teşkil etmediği ve hemotolojik hastalığı olan ile major cerrahi uygulanacak hastalarda güvenle kullanılabileceği şeklinde yorumlanmıştır 13 . Literatürde paroksetin ile ilişkilendirilen kanama bozukluğu gelişen olguların çoğunda paroksetinin kesilmiş ve nefazodon, essitalopram ve bupropion gibi ilaçlarla tedaviye devam edilmiştir 14 .…”

Section: Essitalopramunclassified

A different approach to ecchymosis due to paroxetine

Keskin

2022

Cukurova Medical Journal

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Seçici serotonin gerialım inhibitörleri (SSGİ) sıklıkla reçete edilen ve başlıca depresyon ve anksiyete bozukluklarının tedavisinde kullanılan ilaçlardır. SSGİ ilaçlar serotonin taşıyıcısını inhibe ederek trombositlerdeki serotinin düzeylerinde azalmaya yol açarlar. SSGİ ilaçlar başta paroksetin olmak üzere anormal kanamalarla ilişkilendirilmiştir. Yazıda genç, sağlıklı olup, paroksetin 20 mg/gün kullanımı sonrası spontan ekimoz gelişen, tedavisine paroksetinle devam edilen ve takiplerinde ekimotik lezyonların azalarak geçtiği gözlenen bir olgu sunulmuştur. SSGİ ilaçlarla ilişkili kanama gelişmesi durumunda; belirtiler hafif ve koagülasyon testleri normalse, tedaviye aynı ilaçla devam etmenin de bir seçenek olabileceği akılda tutulmalıdır. Bu konuda geniş ölçekli izlem çalışmalarına ihtiyaç vardır.

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SSRI-induced coagulopathy: is it reality?

Abstract: In patients with depression, fluoxetine increases bleeding time whereas escitalopram has no effect on coagulation profile. However, both the drugs can be used safely for long-term treatment.

Cited by 12 publications

References 18 publications

Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation

Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation

The Extrinsic Coagulation Pathway: a Biomarker for Suicidal Behavior in Major Depressive Disorder

A different approach to ecchymosis due to paroxetine

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