A literature review reveals very low certainty of evidence regarding the potential effect of SSRIs on platelet functions, with highly inconsistent findings across studies.
Do selective serotonin reuptake inhibitors affect platelet functions?
Current evidence on the intrinsic antiplatelet effects of SSRIs is highly inconsistent and of low certainty, necessitating further well-designed studies to account for confounding factors.
PURPOSE OF REVIEW: Many epidemiological studies have evidenced an increased bleeding risk associated with selective serotonin reuptake inhibitors (SSRIs), yet the underlying mechanisms remain unclear. This review summarizes data on SSRIs' effects on platelet functions assessed with assays used in clinical practice and highlights the areas that deserve further investigation. RECENT FINDINGS: Conflicting results of SSRI effects on platelet aggregation were observed irrespectively of the agonist used, the antidepressant drug or the study type. Alike, discrepant results were reported with flow-cytometry-based assays assessing either platelet surface glycoprotein levels, integrin activation, agonist-induced secretion of intraplatelet granule content or membrane anionic phospholipid exposure. Other tests may have detected a platelet function defect in SSRIs samples, however, results were largely inconsistent. SUMMARY: Critical literature examination unveils very low certainty of evidence on potential SSRI effect on platelet functions. Findings are often inconsistent even when similar methods are used, most likely because of differences in study design, included patients (age, comorbid conditions), SSRIs' type and dose, uncontrolled confounding factors, and statistical analysis power. Further studies are needed to disentangle any intrinsic antiplatelet effect of SSRIs and the multiple confounding factors, mainly the depression control itself and the degree of platelet SERT inhibition.
Mokhtarian et al. (Wed,) 在服用 selective serotonin reuptake inhibitors 的患者中进行了一项综述。评估了 selective serotonin reuptake inhibitors (SSRIs) 对血小板功能（聚集、糖蛋白水平、整合素激活、分泌、磷脂暴露）的影响。文献综述显示，关于 SSRIs 对血小板功能潜在影响的证据确定性极低，各项研究之间的结果高度不一致。