SSRI-induced coagulopathy: is it reality?

OBJECTIVES To study the effect of escitalopram and fluoxetine on coagulation profile in patients with major depression. METHOD This was a prospective, open-label, single-centre study in 40 patients diagnosed with major depressive disorder. The patients were diagnosed using Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Twenty patients receiving escitalopram 10 mg per day and 20 patients receiving fluoxetine 20 mg per day participated in the study and were followed up for 3 months. Coagulation parameters - bleeding time, clotting time, platelet count, prothrombin time and partial thromboplastin kaolin time - were evaluated at baseline and after 3 months. RESULTS At the end of 3 months, a significant increase in bleeding time was seen in patients receiving fluoxetine, but within the normal range. No rise was seen in the group given escitalopram. CONCLUSION 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.