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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by amigan on October 10, 2007, at 8:59:21
Hello.
I would like to get a sincere view on how big is the chance of bleeding with the use of antidepressant meds. I don't mean a life-threatening internal bleeding, even a tiny one.Also, there are a few questions i have about this subject:
1. Does this includes all antidepressants with an action on the serotonin (TCA, etc.) or just the SSRIs? Most reports that i have read about this, are about the SSRIs.2. Is this danger greater or lesser than this of aspirin or other "anti-platelet" drugs?
3. Is it dose-depended?
Posted by Netch on October 10, 2007, at 9:27:24
In reply to Antidepressants and bleeding, posted by amigan on October 10, 2007, at 8:59:21
1.
“Among the 196 persons in the study admitted to the hospital with abnormal bleeding, the risk of hospitalization increased with the use of the strongest SSRI antidepressants - that is, those that produce the most inhibition of serotonin reuptake. The risk of being hospitalized for bleeding was twice as high in drugs that produce intermediate inhibition, and about 2.6 times as likely for the drugs that produce high degrees of inhibition.”
Antidepressants with Intermediate Effects:
Venlafaxine (Effexor) - Atypical
Dothiepin (Prothiaden) - Tricyclic
Amitriptyline (Elavil) - Tricyclic
Fluvoxamine (Luvox) - SSRI
Imipramine (Tofranil) - Tricyclic
Citalopram (Celexa) - SSRIAntidepressants with High Effects
Paroxetine (Paxil) - SSRI
Clomipramine (Anafranil) - Tricyclic
Sertraline (Zoloft) - SSRI
Fluoxetine (Prozac) - SSRIIt is important to note that this one study found that less than 1% of its participants developed bleeding difficulties. While those now taking these antidepressants certainly need to be aware of this possibility, there is no need for alarm.
http://bipolar.about.com/od/antidepressants/a/antidepbleeding.htm
2.
The risk of bleeding from TCA/SSRI is less compared to aspirin:
"The researchers analysed 24 previous studies of aspirin, involving almost 66,000 patients.
They found that, on average, bleeding occurred in 2.5% of patients taking aspirin compared with 1.4% who were not. "
http://news.bbc.co.uk/1/hi/health/1014089.stm
3.
Yes, I believe so
"Alderman et al. (28) in their conclusions acknowledge the possibility that abnormal platelet function is more likely to occur when high doses of SSRIs are administered, which is in agreement with the time- and dose-dependent inhibition of platelet release reactions found in the present study. "
http://ajp.psychiatryonline.org/cgi/content/full/162/6/1165
/Netch
Posted by amigan on October 10, 2007, at 10:06:12
In reply to Re: Antidepressants and bleeding » amigan, posted by Netch on October 10, 2007, at 9:27:24
Thank you for your very elaborate post!
Posted by Phillipa on October 10, 2007, at 12:06:41
In reply to Re: Antidepressants and bleeding » Netch, posted by amigan on October 10, 2007, at 10:06:12
Where did you even hear this I've never in four years on this board even heard it mentioned? Bleeding on ad's? Well is this something else new haven't read articles yet. But if current blood work in within normal you should be okay right? And where does the bleeding come from. Could be in on of the articles better read Phillipa
Posted by Phillipa on October 10, 2007, at 12:15:22
In reply to Re: Antidepressants and bleeding » amigan, posted by Netch on October 10, 2007, at 9:27:24
For heart attack and stroke patients as I would think that women of menstrual age would be heavily bleeding from ad use. Phillipa
Posted by amigan on October 10, 2007, at 12:30:58
In reply to Re: Antidepressants and bleeding » amigan, posted by Phillipa on October 10, 2007, at 12:06:41
> Where did you even hear this I've never in four years on this board even heard it mentioned? Bleeding on ad's?
It's a medical fact.
>But if current blood work in within normal you should be okay right?
I suppose so, unless you overdose.
Posted by Phillipa on October 10, 2007, at 12:48:25
In reply to Re: Antidepressants and bleeding, posted by amigan on October 10, 2007, at 12:30:58
Well then the same as aspirin or tylenol so I wouldn't do that anyway . So an average dose is fine.Phillipa
Posted by Netch on October 10, 2007, at 12:57:27
In reply to Re: Antidepressants and bleeding » Netch, posted by Phillipa on October 10, 2007, at 12:15:22
Depression increases the risk of IHD and stroke. Increased bleeding should somewhat protect against IHD and Stroke.
Netch
Posted by Phillipa on October 10, 2007, at 19:24:55
In reply to Re: Antidepressants and bleeding » Phillipa, posted by Netch on October 10, 2007, at 12:57:27
Except two types of strokes one from bleeding like an anyuesm and they the sticky blot clot ones. Kind of a catch 22? Phillipa
Posted by Phillipa on October 10, 2007, at 19:37:49
In reply to Re: Antidepressants and bleeding » Netch, posted by Phillipa on October 10, 2007, at 19:24:55
Here's a bit more info will google antidepressants and stroke too. Phillipa
Stroke
What is a stroke?
What causes a stroke?
What is a TIA?
What is the impact of strokes?
What are stroke symptoms?
What should be done if you suspect you or someone else is having a stroke?
How is a stroke diagnosed?
What is the treatment of a stroke?
What complications can occur after a stroke?
What can be done to prevent a stroke?
What is in the future for stroke treatment?
Stroke At A Glance
Related Stroke articles:
Stroke symptoms – on WebMD
Recognizing a Stroke: Three Commands for the Victim
Medical Author: Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Jay W. Marks, MDThree commands sometimes used by doctors to begin assessing whether a person may be experiencing a stroke can also be useful for people who are not doctors, according to a study by University of North Carolina researchers.
Lay persons can command a potential stroke victim to:
Smile
Raise both arms
Speak a simple sentence
The three commands, known as the Cincinnati Prehospital Stroke Scale (CPSS), are used by health professionals as a simple first step in the assessment process for signs of stroke. If a person has trouble with any of these simple commands, emergency services (911) should be called immediately with a description of the situation, noting that you suspect the individual is having a stroke.A stroke results from impaired oxygen delivery to brain cells via the bloodstream. According to the U.S. National Institute of Neurological Disorders and Stroke, the five major signs of stroke are the sudden onset of:
Numbness or weakness of the face, arm or leg, especially on one side of the body. The loss of voluntary movement and/or sensation may be complete or partial. There may also be an associated tingling sensation in the affected area.
Read the rest of the stroke symptoms »
Top Searched Stroke Terms:
stroke symptoms, management of stroke, signs of a stroke, heat stroke, TIA stroke, stroke recovery, stroke treatment, stroke causes, mini stroke
What is a stroke?
A stroke is the sudden death of brain cells due to a problem with the blood supply. When blood flow to the brain is impaired, oxygen and important nutrients cannot be delivered. The result is abnormal brain function. Blood flow to the brain can be disrupted by either a blockage or rupture of an artery to the brain. There are many causes for a stroke, as shown in the table and discussed below. A stroke is also referred to as a cerebrovascular accident or CVA.
Causes of Stroke
Blockage of artery
Clogging of arteries within the brain (for example, lacunar stroke)
Hardening of the arteries leading to the brain (for example, carotid artery occlusion)
Embolism to the brain from the heart or an artery
Rupture of an artery (hemorrhage)Cerebral hemorrhage (bleeding within the brain substance)
Subarachnoid hemorrhage (bleeding between the brain and the inside of the skull)What causes a stroke?
The blockage of an artery in the brain by a clot (thrombosis) is the most common cause of a stroke. The part of the brain that is supplied by the clotted blood vessel is then deprived of blood and oxygen. The cells of that part of the brain die as a result. Typically, a clot forms in a small blood vessel within the brain that has been previously narrowed due to the long–term, damaging effects of high blood pressure (hypertension) or diabetes. The resulting strokes are called lacunar strokes because they look like little lakes. In other situations, usually because of hardening of the arteries (atherosclerosis), a blood clot can obstruct a larger vessel going to the brain, such as the carotid artery in the neck.
Another type of stroke may occur when a blood clot or a piece of atherosclerotic plaque (cholesterol and calcium deposits on the wall of the inside of the heart or artery) breaks loose, travels through open arteries, and lodges in an artery of the brain. When this happens, the flow of oxygen–rich blood to the brain is blocked and a stroke occurs. This type of stroke is referred to as an embolic stroke. For example, a blood clot might originally form in the heart chamber as a result of an irregular heart rhythm, such as occurs in atrial fibrillation. Usually, these clots remain attached to the inner lining of the heart, but occasionally they can break off, travel through the blood stream, form a plug (embolism) in a brain artery, and cause a stroke. An embolism can also originate in a large artery (for example, the carotid artery, a major artery in the neck that supplies blood to the brain) and then travel downstream to clog a small artery within the brain.
A cerebral hemorrhage occurs when a blood vessel in the brain ruptures and bleeds into the surrounding brain tissue. A cerebral hemorrhage (bleeding in the brain) can cause a stroke by depriving blood and oxygen to parts of the brain. The accumulation of blood from a cerebral hemorrhage can also press on parts of the brain and cause damage. A subarachnoid hemorrhage is caused by the rupture of a blood vessel that is usually located between the outside of the brain and the inside of the skull. The blood vessel at the point of rupture is often previously abnormal, such as from an aneurysm (an abnormal ballooning out of the wall of the vessel). Subarachnoid hemorrhages usually cause a sudden, severe headache and are often complicated by further neurological problems, such as paralysis, coma, and even death.
Overall, the most common risk factors for stroke are high blood pressure and increasing age. Diabetes and certain heart conditions, such as atrial fibrillation, are other common risk factors. When strokes occur in younger individuals (less than 50 years old), less common risk factors are often involved. These risk factors include drugs, such as cocaine or amphetamines, ruptured aneurysms, and inherited (genetic) predispositions to blood clotting. Another example of a genetic predisposition to stroke occurs in a rare condition called homocystinuria, in which there are excessive levels of the chemical homocystine in the body. Furthermore, scientists are trying to determine whether the non–hereditary occurrence of high levels of homocystine at any age can predispose to stroke. Another rare cause of stroke is vasculitis, a condition in which the blood vessels become inflamed. Finally, there appears to be a very slight increased occurrence of stroke in people with migraine headache.
Posted by Phillipa on October 10, 2007, at 19:45:05
In reply to Re: Antidepressants and bleeding » Phillipa, posted by Phillipa on October 10, 2007, at 19:37:49
Oh wow SSRI's and other categories can indeed cause stokes. Phillipa
This article is from the WebMD
Feature Archive
Combining Common Meds May Cause StrokeBy Michael Smith, MD
WebMD Feature Reviewed By Gary Vogin, MD
Jan. 7, 2002 -- Doctors already suspected potential problems could arise from combining drugs that affect the brain chemical called serotonin. And now there are reports of severe headache and even stroke from combining some very popular drugs.
Researchers at Massachusetts General Hospital in Boston reported on three people who developed a sudden, very severe headache and brain changes after taking two or more drugs that affect serotonin levels.
Serotonin is an important chemical messenger found in the brain and throughout the body. Some drugs -- such as antidepressants -- work by increasing levels of serotonin , while others cause the chemical to rise as a side effect.Increased levels of serotonin in the body are known to cause the blood vessels to narrow. When this narrowing occurs in the brain, it can lead to headaches and even strokes from a lack of oxygen and nutrients.
In each of the three people, the researchers were unable to find any cause for their symptoms other than a serotonin overload in the body.
According to the researchers, there is a long list of drugs that can potentially affect serotonin levels in the brain and body. They include:
Newer antidepressants called "SSRIs" -- selective serotonin reuptake inhibitors (examples are Celexa, Paxil, Prozac, and Zoloft)
Migraine medicines called "triptans" (examples are Amerge, Axert, Imitrex, Maxalt, and Zomig)
Diet pills
Amphetamines
St. John's wort -- an herbal supplement commonly used to treat depression
Illicit drugs, including ecstasy (MDMA), cocaine, and methamphetamine (speed, crank, ice, crystal)All three people in this study were taking two or more of the above substances.
The researchers also caution about the affect of combining any of these substances with other drugs that can cause narrowing of blood vessels, such as the decongestant pseudoephedrine -- found in many over-the-counter cold and allergy remedies.
The researchers are not saying that you should absolutely not take two or more of these medications at the same time. But they do suggest discussing with your doctor any potential side effects from taking a combination of the drugs. In addition, if you experience a sudden, unexplained headache, your doctor should consider a combination of these drugs as a potential cause.
Posted by ntdc on October 14, 2007, at 13:11:08
In reply to Re: Antidepressants and bleeding, posted by Phillipa on October 10, 2007, at 19:45:05
Beginning Serzone and Seroquel several years ago, I asked my pharmacist if my aggrivated symptoms of dysmenorreah (painful)and menorrhagia (excessive blood loss) were common. They are uncommon side effects, but mine was even more severe and extremely prolonged (weeks rather than days). After talking with my Natropath she suggested that I take 300mcgs of Vitamin K, up to 3 times a day as needed, as a coagulant. Checking first if this would interfere with my script and otc medications, and naturopathic items, I began this treatment. It was extremely helpful!
Not taking medication but still having this somewhat lessened problem, taking chlorophyll (also a blood cleanser) with naturally occurring Vitamin K has been helpful.
Arnica Montana is another remedy which may assist internally without as many possible interactions with other anticoagulant drugs. Again, definitely check for interactions before beginning what would seem like a benign substance, including foods in your regular diet.
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