Citalopram-induced bleeding due to severe thrombocytopenia.
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.


METHODS
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.


CONCLUSIONS
As this case report shows, drug-induced immune thrombocytopenia may present another possible mechanism for bleeding in SSRI-treated patients.
Andersohn
Frank
F
Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, 10098 Berlin, Germany. frank.andersohn@charite.de
Konzen
Christine
C
Bronder
Elisabeth
E
Klimpel
Andreas
A
Garbe
Edeltraut
E
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000139:chemically induced* / Q000628:therapy; D001792:Blood Platelets / Q000276:immunology; D015283:Citalopram / Q000009:adverse effects* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010976:Platelet Count; D017713:Platelet Transfusion; D011239:Prednisolone / Q000627:therapeutic use; D011693:Purpura / Q000097:blood / Q000139:chemically induced*; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000628:therapy; D014592:Uterine Hemorrhage / Q000097:blood / Q000139:chemically induced*
D018687:Antidepressive Agents, Second-Generation; D001323:Autoantibodies; D007166:Immunosuppressive Agents; D015283:Citalopram; D011239:Prednisolone