title: Coagulation activation and fibrinolysis impairment are reduced in patients with anxiety and depression when medicated with serotonergic antidepressants.
abstract: OBJECTIVE
  Anxiety disorders have been shown to be correlated with an activation of coagulation and impairment of fibrinolysis. The aim of the study was to assess whether medication with a serotonergic antidepressant, which has been associated with abnormal bleeding, may modify this effect.
  
  
  METHODS
  Thirty-one anxiety patients, mostly with comorbid depression, and 31 healthy controls were included in the study. Group differences between anxiety patients medicated with a serotonergic antidepressant, patients without serotonergic antidepressant and controls were assessed for activated partial thromboplastin time, fibrinogen, factor VII, factor VIII, von Willebrand factor, von Willebrand ristocetin cofactor activity, prothrombin fragment 1 + 2, thrombin-antithrombin complex, d-dimer, α2-antiplasmin, plasmin-α2-antiplasmin complex (PAP), tissue plasminogen activator and plasminogen activator inhibitor. Intervening variables, such as age, sex, body mass index and smoking, were accounted for.
  
  
  RESULTS
  We found lower coagulation measures for fibrinogen (P = 0.03) and plasminogen activator inhibitor (P = 0.01), and higher levels of PAP (P = 0.046) in patients with serotonergic antidepressant than in patients without serotonergic antidepressant. When controlling for smoking and body mass index, differences between the two groups were significant for PAP (P = 0.02), von Willebrand ristocetin cofactor activity (P = 0.02) and activated partial thromboplastin time (P = 0.046). Coagulation scores were similar in patients with serotonergic antidepressant to those of healthy controls.
  
  
  CONCLUSIONS
  Serotonergic antidepressants may counteract a procoagulant effect of anxiety and/or depression in anxiety patients.
authors.affiliation: Clinic for Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany. franziska.geiser@ukb.uni-bonn.de
authors.forename: Franziska
authors.initials: F
authors.lastname: Geiser
authors.forename: Rupert
authors.initials: R
authors.lastname: Conrad
authors.forename: Katrin
authors.initials: K
authors.lastname: Imbierowicz
authors.forename: Christian
authors.initials: C
authors.lastname: Meier
authors.forename: Reinhard
authors.initials: R
authors.lastname: Liedtke
authors.forename: Dietrich
authors.initials: D
authors.lastname: Klingmüller
authors.forename: Johannes
authors.initials: J
authors.lastname: Oldenburg
authors.forename: Ursula
authors.initials: U
authors.lastname: Harbrecht
mesh_terms: D000328:Adult; D001007:Anxiety / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology*; D001779:Blood Coagulation Factors / Q000378:metabolism; D015992:Body Mass Index; D003863:Depression / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008297:Male; D010314:Partial Thromboplastin Time / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D012907:Smoking / Q000097:blood
chemical_list: D001779:Blood Coagulation Factors; D017367:Selective Serotonin Reuptake Inhibitors