Citalopram-Induced Bleeding Due to Severe Thrombocytopenia

Background: In case reports and observational studies, serotonin reuptake-inhibitors (SSRIs) have been linked to an increased risk of bleeding, possibly due to platelet dysfunction as a consequence of serotonin-uptake blockade into platelets. Objective: The authors propose that bleeding as a result of SSRI use may also be caused by other mechanisms. Method: Here, the authors report on a 32-year-old woman with hemorrhages resulting from severe drug-induced immune thrombocytopenia after 4 weeks of citalopram therapy. Results: After withdrawal of citalopram and treatment with platelet concentrates and prednisolone, the patient recovered completely. Conclusion: As this case report shows, drug-induced immune thrombocytopenia may present another possible mechanism for bleeding in SSRI-treated patients. (Psychosomatics 2009; 50: 297-298)