Kayhan Fatih, Eken Zahide Eriş, Uguz Faruk
Department of Psychiatry, Mevlana University Faculty of Medicine, Konya, Turkey
Department of Dermatology, Istanbul Bilim University, Faculty of Medicine, Istanbul, Turkey.
Australas Psychiatry. 2015 Aug;23(4):426-8. doi: 10.1177/1039856215586138. Epub 2015 May 11.
The incidence of mild to severe levels of spontaneous bleeding due to the usage of selective serotonin reuptake inhibitors (SSRIs) is relatively low. Although the exact mechanism is not known, it is thought that inhibition of the serotonin transporter together with a decrease in platelet serotonin could be responsible for the bleeding. Therefore, the use of SSRIs in conjunction with anti-aggregants may predispose to or exacerbate the risk of bleeding. In this case report, we describe a 44-year-old female patient with a diagnosis of anxiety disorder who spontaneously developed periorbital purpura during treatment with sertraline.
Abnormal bleeding after treatment with an SSRI should be kept in mind, and alternative non-SSRI drugs of choice in such cases would be more appropriate. More extensive and comprehensive studies focusing on hemostasis and bleeding disorders are needed for SSRIs such as sertraline.
使用选择性5-羟色胺再摄取抑制剂（SSRI）导致轻度至重度自发性出血的发生率相对较低。尽管确切机制尚不清楚，但据认为，血清素转运蛋白的抑制以及血小板血清素的减少可能是出血的原因。因此，将SSRI与抗血小板药物联合使用可能会增加或加剧出血风险。在本病例报告中，我们描述了一名44岁诊断为焦虑症的女性患者，在用舍曲林治疗期间自发出现眶周紫癜。
应牢记使用SSRI后出现异常出血的情况，在这种情况下选择其他非SSRI药物更为合适。对于舍曲林等SSRI，需要开展更多关于止血和出血性疾病的广泛而全面的研究。
