Case Report: Life-Threatening Fluoxetine-Linked Postoperative Bleeding Informed by Pharmacogenetic Evaluation

Sara Rogers; Patrick J Silva; George Udeani; Monica Deleon; Sriarchala Mutyala; Ladan Panahi; Asim Abu-Baker; Gabriel Neal; Kenneth S Ramos

doi:10.1007/s40268-023-00451-5

Case Report: Life-Threatening Fluoxetine-Linked Postoperative Bleeding Informed by Pharmacogenetic Evaluation

Drugs R D. 2024 Mar;24(1):117-121. doi: 10.1007/s40268-023-00451-5. Epub 2024 Feb 28.

Authors

Sara Rogers^{1

2

3

4}, Patrick J Silva^{5

6}, George Udeani^{7

5

6}, Monica Deleon⁷, Sriarchala Mutyala⁷, Ladan Panahi⁷, Asim Abu-Baker⁷, Gabriel Neal⁸, Kenneth S Ramos^{5

6}

Affiliations

¹ Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, 78363, USA. sararogers@tamu.edu.
² Department of Translational Medical Sciences, School of Medicine, Texas A&M Health Science Center, Bryan, TX, 77807, USA. sararogers@tamu.edu.
³ Center for Genomic and Precision Medicine, Institute of Biosciences and Technology, Texas A&M University, Houston, TX, USA. sararogers@tamu.edu.
⁴ American Society of Pharmacovigilance, Houston, TX, 77225, USA. sararogers@tamu.edu.
⁵ Department of Translational Medical Sciences, School of Medicine, Texas A&M Health Science Center, Bryan, TX, 77807, USA.
⁶ Center for Genomic and Precision Medicine, Institute of Biosciences and Technology, Texas A&M University, Houston, TX, USA.
⁷ Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, 78363, USA.
⁸ Department of Primary Care and Rural Medicine, School of Medicine, Texas A&M Health Science Center, Bryan, TX, 77807, USA.

Abstract

Background: Selective serotonin reuptake inhibitors (SSRI) are commonly used for the treatment of depression and anxiety. Inhibition of serotonin reuptake in platelets increases bleeding risk in patients taking SSRIs.

Case: Here, we present the case of a 52-year-old patient who developed severe postsurgical bleeding requiring blood transfusion following panniculectomy.

Conclusion: SSRI-induced bleeding is dose-related and strongly influenced by individual variations in drug metabolizing enzymes and transporters. Supplementary file1 (MP4 8441 KB).