Ecchymoses as an adverse effect of fluoxetine treatment

Ecchymosis Due to Sertraline Use: A Case Report

“…Treatment was changed to sertraline. Her depressive symptoms resolved within the next 4 weeks and the ecchymoses gradually disappeared about 6 weeks later while she was still on sertraline treatment (6). This finding suggest that SSRIs do not have the same mechanism of action for their side effects on the hematological system.…”

“…Limited literature available supports the use of another SSRI. In a similar case, Fountalakis et al have preferred sertraline over fluoxetine which caused ecchymosis (6). Although a SNRI may be used as an alternative, it should be remembered that ecchymosis due to venlafaxine, which is a SNRI, has also been reported (12).…”

Fluoxetine-related ecchymosis treated with venlafaxine: a case report

“…Previous case reports described development of side effects including ecchymosis and purpura related with the use of paroxetine and sertraline [9,10]. Nevertheless, most of the ecchymosis cases during the use of SSRIs, as reported in the literature, were indeed related with the use of fluoxetine [3,4,11]. Our case had normal platelet count and her activated partial thromboplastin time and bleeding times were within normal ranges, suggesting that fluoxetine acts by impairing platelet aggregation or inhibiting serotonin reuptake in the platelets without affecting platelet count or blood clotting factors [7].…”

“…There are a growing number of studies reporting an increased risk of bleeding with the use of these agents [2]. In addition, similar to the other SSRIs, fluoxetine also rarely causes ecchymosis and the literature mostly includes case reports of this side effect [3,4]. Here, we report a case of depression who developed ecchymosis after the initiation of fluoxetine and was successfully treated with venlafaxine.…”

Nasal Bleeding Associated with Fluoxetine and Risperidone Interaction: A Case Report

“…Antagonism of the 5-HT2A receptor is proposed to reduce platelet aggregation and inhibit the release of vasoconstrictors from platelets. Abnormal bleeding has been reported with diff erent selective serotonin reuptake inhibitors (SSRIs) [1,2] . The most frequent haemostatic abnormalities are decreased platelet aggregability and activity.…”