Citalopram-induced bleeding due to severe thrombocytopenia

Psychosomatics. 2009 May-Jun;50(3):297-8. doi: 10.1176/appi.psy.50.3.297.

Abstract

Background: In case reports and observational studies, serotonin reuptake-inhibitors (SSRIs) have been linked to an increased risk of bleeding, possibly due to platelet dysfunction as a consequence of serotonin-uptake blockade into platelets.

Objective: The authors propose that bleeding as a result of SSRI use may also be caused by other mechanisms.

Method: Here, the authors report on a 32-year-old woman with hemorrhages resulting from severe drug-induced immune thrombocytopenia after 4 weeks of citalopram therapy.

Results: After withdrawal of citalopram and treatment with platelet concentrates and prednisolone, the patient recovered completely.

Conclusion: As this case report shows, drug-induced immune thrombocytopenia may present another possible mechanism for bleeding in SSRI-treated patients.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents, Second-Generation / adverse effects*
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Autoantibodies / blood
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / chemically induced*
  • Autoimmune Diseases / therapy
  • Blood Platelets / immunology
  • Citalopram / adverse effects*
  • Citalopram / therapeutic use
  • Depressive Disorder, Major / blood
  • Depressive Disorder, Major / drug therapy*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Platelet Count
  • Platelet Transfusion
  • Prednisolone / therapeutic use
  • Purpura / blood
  • Purpura / chemically induced*
  • Thrombocytopenia / blood
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / therapy
  • Uterine Hemorrhage / blood
  • Uterine Hemorrhage / chemically induced*

Substances

  • Antidepressive Agents, Second-Generation
  • Autoantibodies
  • Immunosuppressive Agents
  • Citalopram
  • Prednisolone