RESEARCH - SSRIs: measurement of effect on platelet function

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Transl Res. 2008 Mar;151(3):168-172. Epub 2007 Nov 20.

Selective serotonin reuptake inhibitors: measurement of effect on

platelet function.

McCloskey DJ, Postolache TT, Vittone BJ, Nghiem KL, Monsale JL, Wesley

RA, Rick ME.

National Institutes of Health, Warren Grant Magnuson Clinical Center,

Department of Laboratory Medicine, Bethesda, MD.

Selective serotonin reuptake inhibitors (SSRIs) reduce platelet

serotonin and are associated with increased gastrointestinal bleeding,

an effect that is enhanced when taken with NSAIDs or aspirin. The best

method to evaluate hemorrhagic events in patients taking SSRIs has not

been determined. Platelet aggregation, which is not widely available,

shows SSRI inhibition of platelet function; we tested whether a

platelet function analyzer could detect SSRI inhibition of platelet

function. Two groups of outpatients with mood disorders were

recruited; each patient was taking a stable dose of either an SSRI or

bupropion for at least 6 weeks. They were tested using the platelet

function analyzer-100 (PFA-100; Dade International Inc, Miami, Fla)

concomitantly with platelet aggregation. Fifty-eight patients were

analyzed. We detected significant differences between the groups using

aggregation methods with arachidonic acid (aggregation, P = 0.00001;

release, P = 0.009) and collagen (aggregation, P = 0.016; release, P =

0.006). The PFA-100 did not detect differences between the groups or

results outside the reference range. The PFA-100 does not detect the

inhibitory effects of SSRIs on platelet function, but it can be used

to direct evaluation of bleeding in a patient taking an SSRI. Abnormal

PFA-100 results suggest additional evaluation for von Willebrand

disease, other platelet inhibitory medications, or underlying

intrinsic platelet dysfunction.

PMID: 18279816

http://www.ncbi.nlm.nih.gov/pubmed/18279816

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