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Comment in:
[Increased
perioperative blood loss during treatment with
paroxetine]
[Article in Dutch]
Sewnath ME,
van Hillegersberg R, Koopman MM, Levi MM, Gouma
DJ.
Academisch Medisch Centrum/Universiteit van Amsterdam,
Postbus 22.660, 1100 DD Amsterdam. m.e.sewnath@amc.uva.nl
A
63-year-old man who took paroxetine for depression developed massive
peroperative haemorrhage during a pancreaticoduodenectomy as a result of
paroxetine-induced thrombocytopathy. He lost 4 litres of blood. After
administration of 8 units of fresh frozen plasma and 2 times 5 units of
thrombocyte concentrate, hemostatic control was obtained and the
operation could be continued. Paroxetine is a non-tricyclic serotonin
reuptake inhibitor prescribed for the treatment of depression. Since
this drug also blocks serotonin reuptake in platelets, a clinically
significant platelet dysfunction can occur under certain conditions.
Because serotonin promotes platelet aggregation, too low an amount of
serotonin in the platelets can result in thrombocytopathy. Before major
surgery, it is advised to perform extensive clotting tests if there is
any hint of haemorrhagic diathesis in the anamnesis. In case of a
prolonged bleeding time, paroxetine treatment should be stopped
perioperatively.
Publication Types:
PMID: 12369443 [PubMed - indexed for
MEDLINE]
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