The effect of Selective Serotonin Reuptake Inhibitors on primary hemostasis: Non-clinical, clinical, and epidemiological data

Details

Supervisors

SIRIEZ Romain

Faculty

Faculté de pharmacie et des sciences biomédicales

Degree label

Master [120] en sciences pharmaceutiques, à finalité spécialisée

Abstract

Major depressive disorder is the most prevalent disabling psychiatric disease and has a lifetime prevalence of 14.1% in Belgium. Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed drug class for the treatment of depression and a number of other psychiatric affections because of their efficacy and high tolerability. In recent years, SSRIs have been at the center of an increasing number of case reports suggesting their association with rare but potentially severe bleeding episodes. The proposed mechanism explaining these revolves around the inhibition of serotonin transport into platelets resulting in reduced aggregation. This review’s first objective is to explain the mechanisms through which SSRI treatment affects primary hemostasis, and to offer both quantitative and qualitative data on the risk of clinically significant abnormal bleeding. The second objective is to evaluate the effect of concomitant drug use on SSRI-induced bleeding risks. The third and final objective is to discuss practical strategies for the clinical management of bleeding in high-risk patients.