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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2004, Number 4

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An Med Asoc Med Hosp ABC 2004; 49 (4)

Secondary hemorrhagic trombocytopenia to the antidepressant drug therapy in aesthetic surgery

Valero OUJ, García VJ, Seguí VP, García CS, Rizo SG

Language: Spanish
References: 27
Page: 196-200
PDF size: 50.77 Kb.


ABSTRACT

There are medications that modify platelet function, but only a few are suspended prior to surgery. Selective serotonin re-uptake inhibitors are the ones most prescribed for depression. The WHO estimates 400 million people are affected by depression, and will be in second place on the tables of mortality in the near future. A high percentage of esthetic surgery patients suffer depression, and are under pharmacological treatment. These medications cause a deficit of platelet aggregation and are predisposed to hemorrhaging in different levels, from bruising, epistaxis, genitourinary, gastrointestinal, and intracranial bleeding. We present the case of a patient with chronic depression treated with selective serotonin re-uptake inhibitor that had abdominoplastic liposuction, and breast reduction surgery, that presented unusual trans-surgical bleeding and post-surgical anemic syndrome, secondary to treatment with selective serotonin re-uptake inhibitors. Because the use of selective serotonin re-uptake inhibitors used to treat depression is gradually increasing, plastic surgeons and other specialists need to be careful and wise when planning surgery for this type of patients.


REFERENCES

  1. Rifkind RA et al. Mecanismos normales de hemostasia en hematología clínica. 3a ed. México: Interamericana, 1988; 167-178.

  2. Goldberg RJ. Selective serotonin reuptake inhibitors infrequent medical adverse effects. Arch Fam Med 1998; 1: 78-84.

  3. Jusset T, García N, Andrés I, Lamas A. Manejo farmacológico de la depresión en la atención primaria. Rev Arg Clin Neuropsiquiat 2003; 1: 10-21.

  4. De Abajo FJ, Garcia R, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: Population based case-control study. BMJ 1999; 319: 1106-1109.

  5. Solis SJA (ed). Diccionario de especialidades farmacéuticas. 50a ed. México: Ediciones PLM, 2004; 2504-2505.

  6. Garcia N, Jusset T, Rosete G, Elio M. Tratamiento farmacológico de la depresión mayor. Rev Cub Med Gen Integr 2002; 18: 213-219.

  7. Breton S. La depresión en México. México: Editorial Planeta, 1998; 8-40, 90-95

  8. Len A, Tort B, Sanchez A et al. Tratamiento antidepresivo y hematoma subcapsular esplénico. An Med Inter Madrid 2003, 9: 56-57.

  9. Pai VB, Kelly MW. Bruising associated with the use of fluoxetine. Ann Pharmacother 1996; 30: 786-788.

  10. Aranth J, Lindberg C. Bleeding, a side effect of fluoxetine. Am J Psychiatry 1992; 3: 412.

  11. Ottervanger JP, Van den Bemt PM, De Koning GH, Stricker BH. Risk of hemorrhage with the use of fluoxetine (Prozac) or fluvoxamine (Fevarin). Ned Tijdschr Geneeskd 1993; 137: 259-261.

  12. Linnebur SA, Saseen J, Pace WD. Venlafaxine-associated vaginal bleeding. Pharmacotherapy 2002; 22: 652-655.

  13. Pai VB, Kelly MW. Bruising associated with the use of fluoxetine. Ann Pharmacother 1996; 30: 786-788.

  14. Cailleux N, Marie I, Chretien MH, Noblet C, Levesque H, Courtois H. Spontaneous hematoma: Thoughts about selective serotonin uptake inhibitors. J Mal Vasc 2000; 25: 63-64.

  15. Alderman CP, Seshadri P, Ben-Tovim DI. Effects of serotonin reuptake inhibitors on hemostasis. Ann Pharmacother 1996; 30: 1232-1234.

  16. Yaryura-Tobias JA, Kirschen H, Ninan P, Mosberg HJ. Fluoxetine and bleeding in obsessive-compulsive disorder. Am J Psychiatry 1991; 148: 949.

  17. Fundación Instituto Catalán de Farmacología Universidad Autónoma de Barcelona. Tarjeta amarilla. Butlleti Groc 2000; 13: 1-3.

  18. Artigas F, Sarris MJ, Martinez E et al. Serotonin in body fluids: Characterization of human and cerebrospinal fluid pools by means of a new HPLC method. Life Sci 1985; 37: 441-447.

  19. Celada P, Dolera M, Alvqrez E et al. Effects of acute and chronic treatment with fluvoxamine on extracellular and platelet serotonin in the blood of major depressive patients: relationships to clinical improvement. J Affect Disord 1992; 25: 243-249.

  20. Lesch KP, Wolozin BL, Murphy DL, Reiderer R. Primary structure of the human platelet serotonin uptake site: identity with the brain serotonin transporter. J Neurochem 1993; 60: 2319-232.

  21. Wagner A, Montero D, Martensson B, Siwers B, Asberg M. Effects of fluoxetine treatment of platelet 3H-imipramine binding, 5-HT uptake and 5-HT content in major depressive disorder. J Affect Dis 1990; 20: 101-113

  22. Ross SB, Apenia B, Beck-Friis J, Jansa S, Wetteberg L, Aberg A. Inhibition of 5-hydroxytryptamine uptake in human platelets by antidepressants agents in vivo. Psychopharmacology 1980; 67: 1-7.

  23. Stahl S. Platelets as pharmacologic models for the receptors and biochemistry of monoaminergic neurons in the platelets. In: Longnecker GL (ed). Physiology and pharmacology. Orlando, Fl: Academic Press, 1985; 307-340.

  24. Sanchez B. Inhibidores de la recaptación de serotonina y hemorragia digestiva. Bol Terapeut 2003; 1: 1-4.

  25. Skop B, Brown T. Potential vascular and bleeding complications of treatment with selective serotonin reuptake inhibitors. Psychosomatics 1996; 37: 12-16.

  26. Humphries JE, Wheby MS, VandenBerg SR. Fluoxetine and the bleeding time. Arch Pathol Lab Med 1990; 114: 727-728.

  27. Alain Li Wan Po. Antidepressants and upper gastrointestinal bleeding. BMJ 1999; 319: 1081-1082.




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