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Platelet counts in depressed patients treated with amitriptyline or paroxetine

Published online by Cambridge University Press:  16 April 2020

F. Lederbogen*
Central Institute of Mental Health, J5, 68159Mannheim, Germany
E. Hörer
Central Institute of Mental Health, J5, 68159Mannheim, Germany
R. Hellweg
Department of Psychiatry, Free University, Berlin, Germany
I. Heuser
Central Institute of Mental Health, J5, 68159Mannheim, Germany Department of Psychiatry, Free University, Berlin, Germany
M. Deuschle
Central Institute of Mental Health, J5, 68159Mannheim, Germany
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To assess whether therapy with two widely used antidepressants influences platelet counts.

Subjects and methods

In 90 patients hospitalized for treatment of a major depressive episode according to DSM-IV, platelet counts were performed after a 6 d antidepressant-free run-in period and again after 35 d of active standardized treatment with amitriptyline (n = 40) or paroxetine (n = 50).


There was a trend for platelet counts to increase during treatment with amitriptyline (from 245.5 ± 68.6 to 256.8 ± 69 cells × 109 L-1, P < 0.06); no change was observed during treatment with paroxetine (from 232.6 ± 58.3 to 234.6 ± 68.9 cells × 109 L-1, n.s).


Treatment with amitriptyline tends to be associated with elevated platelet counts. The cause for this increase is not known, but may be relevant in terms of patients’ long-term thromboembolic risk.

Short communication
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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Ariyo, AA, Haan, M, Tangen, CM, Rutledge, JC, Cushman, M, Dobs, A, et al. Depressive symptoms and risks of coronary heart disease and mortality in elderly Americans. Circulation 2000;102: 1773–9.CrossRefGoogle ScholarPubMed
Berk, M, Jacobson, BF, Hurly, E.Fluoxetine and hemostatic function: a pilot study. J Clin Psychiatry 1995;56:14–6.Google ScholarPubMed
Canoso, R.Effects of neuroleptics on the immune system. In: Kane, JM, Lieberman, JA, editors. Adverse effects of psychotropic drugs. NewYork: The Guilford Press; 1992. p. 395–487.Google Scholar
Deuschle, M, Hamann, B, Meichel, C, Krumm, B, Lederbogen, F, Kniest, A, et al. Antidepressive treatment with amitriptyline and paroxetine: effects upon saliva cortisol concentrations. J Clin Psychopharmacol (in press).Google Scholar
Glassman, A, Shapiro, PA.Depression and the course of coronary artery disease. Am J Psychiatry 1998;155:4–11.CrossRefGoogle ScholarPubMed
Heuser, I.The hypothalamic-pituitary-adrenal system in depression. Pharmacopsychiatry 1998;31:10–3.CrossRefGoogle ScholarPubMed
Hoeksema, T, Goekoop, JG, Van Kempen, GMJ.Effects of fluvoxamine on whole-blood serotonin and platelet number. J Clin Psychopharmacol 1993;13:75–6.CrossRefGoogle ScholarPubMed
Krivy, J, Wiener, J.Sertraline and platelet counts in idiopathic thrombocytopenia purpura. Lancet 1995;345:132.CrossRefGoogle ScholarPubMed
Lake, MB, Birmaher, B,Wassick, S, Mathos, K,Yelovich, AK.Bleeding and selective serotonin reuptake inhibitors in childhood and adolescence. J Child Adolesc Psychopharmacol 2000;10:35–8.CrossRefGoogle ScholarPubMed
Lederbogen, F, Gilles, M, Maras, A, Hamann, B, Colla, M, Heuser, I, et al. Increased platelet aggregability in major depression? Psychiatry Res 2001;102:255–61.CrossRefGoogle ScholarPubMed
Maes, M, Scharpe, S, Bosmans, E, Vandewoude, M, Suy, E, Uyttenbroeck, W, et al. Disturbances in acute phase plasma proteins during melancholia: additional evidence for the presence of an inflammatory process during that illness. Prog Neuropsychopharmacol Biol Psychiatry 1992;16:501–15.CrossRefGoogle ScholarPubMed
Markovitz, JH, Matthews, KA, Kiss, J, Smitherman, TC.Effects of hostility on platelet reactivity to psychological stress in coronary heart disease patients and in healthy controls. Psychosom Med 1996;58: 143–9.CrossRefGoogle ScholarPubMed
Musselman, DL, Tomer, A, Manatunga, AK, Knight, BT, Porter, MR, Kasey, S, et al. Exaggerated platelet reactivity in major depression. Am J Psychiatry 1996;153:1313–7.Google ScholarPubMed
Musselman, DL, Marzec, UM, Manatunga, A, Penna, S, Reemsnyder, A, Knight, BT, et al. Platelet reactivity in depressed patients treated with paroxetine: preliminary findings. Arch Gen Psychiatry 2000;57: 875–82.CrossRefGoogle ScholarPubMed
Seidel, A, Arolt, V, Hunstiger, M, Rink, L, Behnisch, A, Kirchner, H.Major depressive disorder is associated with elevated monocyte counts. Acta Psychiatr Scand 1996;94:198–204.Google ScholarPubMed
Taniguchi, S, Hamada, T.Photosensitivity and thrombocytopenia due to amitriptyline. Am J Hematol 1996;53:49–50.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Thaulow, E, Erikssen, J, Sandvik, L, Stormorken, H, Cohn, PF.Blood platelet count and function are related to total and cardiovascular death in apparently healthy men. Circulation 1991;84:613–7.CrossRefGoogle ScholarPubMed
Van Kempen, GMJ, Zitman, FG, Linssen, ACG, Edelbrock, PM.Biochemical measures in patients with a somatoform pain disorder, before, during and after treatment with amitriptyline with or without flupentixol. Pain 1991;47:25–30.Google Scholar
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