[Increased perioperative blood loss during treatment with paroxetine].

Abstract

A 63-year-old man who took paroxetine for depression developed massive peroperative haemorrhage during a pancreaticoduodenectomy as a result of paroxetine-induced thrombocytopathy. He lost 4 litres of blood. After administration of 8 units of fresh frozen plasma and 2 times 5 units of thrombocyte concentrate, hemostatic control was obtained and the operation could be continued. Paroxetine is a non-tricyclic serotonin reuptake inhibitor prescribed for the treatment of depression. Since this drug also blocks serotonin reuptake in platelets, a clinically significant platelet dysfunction can occur under certain conditions. Because serotonin promotes platelet aggregation, too low an amount of serotonin in the platelets can result in thrombocytopathy. Before major surgery, it is advised to perform extensive clotting tests if there is any hint of haemorrhagic diathesis in the anamnesis. In case of a prolonged bleeding time, paroxetine treatment should be stopped perioperatively.

• Authors: M E Sewnath, R van Hillegersberg, M M W Koopman, M M Levi, D J Gouma
• Journal: Nederlands tijdschrift voor geneeskunde (Ned Tijdschr Geneeskd) Vol. 146 Issue 38 Pg. 1800-2 (Sep 21 2002) ISSN: 0028-2162 [Print] Netherlands
• Vernacular Title: Toegenomen peroperatief bloedverlies bij paroxetinegebruik.
• PMID: 12369443 (Publication Type: Case Reports, English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents, Second-Generation
• Serotonin Uptake Inhibitors
• Paroxetine

Topics

• Antidepressive Agents, Second-Generation (adverse effects, therapeutic use)
• Blood Loss, Surgical
• Blood Platelet Disorders (chemically induced)
• Depression (drug therapy)
• Humans
• Male
• Middle Aged
• Paroxetine (adverse effects, therapeutic use)
• Platelet Aggregation (drug effects)
• Selective Serotonin Reuptake Inhibitors (adverse effects, therapeutic use)