Paroxetine decreases platelet serotonin storage and platelet function in human beings

Hergovich, Nicole; Aigner, Martin; Eichler, Hans‐Georg; Entlicher, Jesusa; Drucker, Christa; Jilma, Bernd

doi:10.1067/mcp.2000.110456

Cited by 195 publications

(183 citation statements)

References 35 publications

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“…Antidepressants that prevent the uptake of serotonin into platelets may thereby inhibit the only mechanism for platelet storage of serotonin. 4 All of the high-affinity SSRIs represented in the present study have been shown to reduce platelet aggregation. 5,[13][14][15] We know of no studies that have suggested altered platelet activity attributed to the other antidepressants with low or moderate serotonin transporter affinity; however, one study demonstrated no effect of nortriptyline on platelet activity.…”

Section: Potential Role Of Serotonin Reuptake Inhibitors In Preventiomentioning

confidence: 99%

“…1,2 A genetic polymorphism of the serotonin transporter (the only mechanism for serotonin uptake into platelets) causes increased serotonin uptake and is associated with an increased risk of MI. 3 Antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs) with high affinity for the serotonin transporter, attenuate platelet activation by depleting serotonin storage 4 and have been shown to decrease platelet activity in patients with coronary artery disease. 5 The antiplatelet effects of SSRIs, most of which have high affinity for the serotonin transporter, have been implicated in an increased risk of gastrointestinal bleeding 6 and lower risk of MI among users of SSRIs.…”

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confidence: 99%

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Effect of Antidepressants and Their Relative Affinity for the Serotonin Transporter on the Risk of Myocardial Infarction

2003

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Background-Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), attenuate platelet activation by depleting serotonin storage and may decrease risk of myocardial infarction (MI). These drugs differ in their affinity for the platelet serotonin transporter and therefore may vary in their effects on MI protection. Methods and Results-A case-control study of first MI in patients aged 40 through 75 years was conducted among 36 hospitals in a 5-county area during a 3-year period. Case subjects were patients hospitalized with a first MI, and control subjects were randomly selected from the same geographic area. Detailed information regarding medication use and other clinical and demographic data were obtained by telephone interview. Among the 1080 cases and 4256 controls who participated, there were 223 users of antidepressants with high serotonin transporter affinity, all of which were SSRIs (paroxetine, fluoxetine, and sertraline). After adjustment with multivariable logistic regression for age, gender, race, education, physical activity, quantity of cigarettes smoked per day, body mass index, aspirin use, family history of MI, and history of diabetes, hypertension, or hypercholesterolemia, the odds ratio for MI among current users of antidepressants with high serotonin transporter affinity compared with nonusers was 0.

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Section: Potential Role Of Serotonin Reuptake Inhibitors In Preventiomentioning

confidence: 99%

mentioning

confidence: 99%

Effect of Antidepressants and Their Relative Affinity for the Serotonin Transporter on the Risk of Myocardial Infarction

2003

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“…In studies performed in human beings all SSRIs have consistently shown a drastic decrease in platelet serotonin content after several weeks of treatment reaching levels around or below 10% of the pretreatment serotonin levels (Wagner et al 1990;Mück-Seler et al 1991;Narayan et al 1998;Hergovich et al 2000;Javors et al 2000) (fig. 1).…”

Section: Pharmacology Of Ssris On Platelets and The Biological Plausimentioning

confidence: 99%

Antidepressants and Risk of Upper Gastrointestinal Bleeding

Abajo

Montero

Rodrı́guez

et al. 2006

Basic Clin Pharma Tox

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“…1 During treatment with SSRIs, the intraplatelet serotonin content is reduced as a result of inhibition of the serotonin reuptake mechanism. 5 Bleeding complications during SSRI treatment could be due to an impaired hemostatic response. Conversely, it is conceivable that SSRIs might reduce the risk of thrombus formation, although the effect of SSRI exposure on the risk of ischemic stroke has not been previously studied.…”

mentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors and the Risk of Stroke

Tsiropoulos

Kjærsgaard

et al. 2002

Stroke

125

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Background and Purpose-Selective serotonin reuptake inhibitors (SSRIs) have been associated with increased risk of bleeding complications, possibly as a result of inhibition of platelet aggregation. Little is known about the risk of intracerebral hemorrhage in users of SSRIs and whether the effect on platelet aggregation reduces the risk of ischemic stroke. We used population-based data to estimate the risk of hemorrhagic and ischemic stroke in users of SSRIs. Methods-We performed a nested case-control study in Funen County (465 000 inhabitants), Denmark. All patients with a first-ever stroke discharge diagnosis in the period of 1994 to 1999 were identified, and a validated diagnosis of stroke was reached in 4765 cases. In all, 40 000 controls were randomly selected from the background population. Information on drug use for cases and controls was retrieved from a prescription registry with full coverage of the county. Odds ratios were adjusted for age, sex, calendar year, and use of other medication. To evaluate the effect of various potential confounders not recorded in the register data, we performed separate analyses on data from 2 large population-based surveys with more detailed information on risk factors. Results-Of 659 patients with hemorrhagic stroke, 21 were current users of SSRIs. The adjusted odds ratio of hemorrhagic stroke in current SSRI users compared with never users was 1.0 [95% confidence interval (CI), 0.6 to 1.6]. Of 2717 patients with ischemic stroke, 100 were current users of SSRIs, and the adjusted odds ratio of ischemic stroke in cases compared with controls was 1.1 (95% CI, 0.9 to 1.4). The survey data indicated that additional confounder control would not have led to an increase in the relative risk estimates. Conclusions-Current exposure to SSRIs is not associated with increased risk of intracerebral hemorrhage and is probably not associated with a decreased risk of ischemic stroke.

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Paroxetine decreases platelet serotonin storage and platelet function in human beings

Cited by 195 publications

References 35 publications

Effect of Antidepressants and Their Relative Affinity for the Serotonin Transporter on the Risk of Myocardial Infarction

Effect of Antidepressants and Their Relative Affinity for the Serotonin Transporter on the Risk of Myocardial Infarction

Antidepressants and Risk of Upper Gastrointestinal Bleeding

Selective Serotonin Reuptake Inhibitors and the Risk of Stroke

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