Platelet function in patients with major depression

Abstract

Depression, ischaemic heart disease and cerebrovascular disease are important causes of morbidity and are among the leading contributors to global health burden. These conditions often occur in the same patient, resulting in considerably greater effect on health than combinations of chronic diseases without depression. The frequent occurrence of these conditions in the same patient raises the possibility of a common genetic predisposition, similar risk factors or a pathophysiological link. Serotoninergic and adrenergic signalling play important roles in causing major depression and also in platelet activation and aggregation, which underlies vascular disease. This review discusses the potential pathophysiological link between major depression and conditions in which platelet activation plays an important role and also provides evidence linking the use of the most commonly used antidepressant drugs (i.e. the selective serotonin re-uptake inhibitors) to increased risk of bleeding.

Depression and cardiac risk: present status and future directions

“…Many cardiotoxic pathways have been suggested,28 including depression-related changes in autonomic balance,29 platelet reactivity,30 inflammation31 and endothelial function 11 32 33. None of these factors have been shown to be strong enough individual mediators of the association between depression and cardiac events to act as proxy outcomes for prevention trials.…”

Cortisol, Platelet Serotonin Content, and Platelet Activity in Patients With Major Depression and Type 2 Diabetes

“…5-HT itself promotes platelet aggregation directly and indirectly via potentiating the effects of collagen and ADP on platelet aggregation (30). Thus, changes in the serotonergic signaling systems in platelets have been assumed in depression (31), which might promote platelet aggregation.…”

Platelets in psychiatric disorders

“…Platelets abnormalities in depressed patients are mainly found in the serotoninergic and noradrenergic system. The uptake, storage and metabolism of serotonin are altered as well as the density of noradrenergic receptors is changed [17] . Basically, serotonin mediates positive affect and mood in the healthy brain, thus the balance of serotonin metabolism may play a central role in the pathogenesis of depression.…”