Key result
Citalopram therapy did not lead to statistically significant inhibition of platelet aggregation compared to placebo in ischaemic stroke patients treated with clopidogrel (mean PRU 116 vs 136, p=0.14).
Why the study?
The study evaluated the effect of SSRI treatment on platelet aggregation in patients with ischaemic stroke.
Does citalopram reduce platelet aggregation in patients with ischaemic stroke treated with clopidogrel?
RCT (n=60)
Double-blind
1:1
Yes
Does citalopram reduce platelet aggregation in patients with ischaemic stroke treated with clopidogrel?
In patients with ischemic stroke on clopidogrel, the addition of citalopram did not significantly inhibit platelet aggregation, suggesting no major synergistic antiplatelet effect.
Citalopram shows no significant antiplatelet effect with clopidogrel; extends RCT evidence against clinically relevant SSRI-P2Y12 interaction in stroke.
We evaluated the effect of SSRI treatment on platelet aggregation in patients with ischaemic stroke and included patients from the randomized double-blind controlled study of citalopram in acute ischaemic stroke (TALOS). Patients on clopidogrel were included 6 months after acute ischaemic stroke. Platelet parameters, including P2Y12 platelet reactivity using the VerifyNow System, were measured at the last day of study treatment and repeated after a 14-day wash-out period. A total of 60 patients were included (n = 32 randomized to citalopram). Platelet aggregation levels did not differ between the citalopram group (mean 116, 95% CI 89 to 143) and the placebo group (mean 136, 95% CI 109 to 163) (On-treatment, p = 0.14). Similarly, there was no significant change in platelet aggregation in the citalopram group from on-treatment to post-treatment (mean difference 2.0; 95% CI -18 to 14). Platelet count, size and turnover were not affected by SSRI treatment. In conclusion, SSRI therapy did not lead to statistically significant inhibition of platelet aggregation in ischaemic stroke patients treated with clopidogrel.
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Kraglund et al. (2019) conducted an RCT in Ischaemic stroke (n=60). Citalopram vs. Placebo was evaluated on ADP-induced platelet aggregation (P2Y12 Reaction Units) (p=0.14). Citalopram therapy did not lead to statistically significant inhibition of platelet aggregation compared to placebo in ischaemic stroke patients treated with clopidogrel (mean PRU 116 vs 136, p=0.14).
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