Does Pristiq Cause Bruising? (+3 warning signs)

In this article, we will discuss whether Pristiq causes bruising. We will also share the mechanisms through which it can cause bruising, its other side effects, some warning signs, and other related information. 

Does Pristiq Cause Bruising? 

Yes, Pristiq may cause bruising in some individuals. Although it is a rarely reported side effect of Pristiq, bruising may occur in some individuals taking Pristiq. Pristiq or desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) and is an antidepressant. 

Pristiq works by blocking the reuptake of serotonin and norepinephrine and thus increasing their concentration in the brain (1). Due to the established role of serotonin in platelet aggregation, Pristiq can make an individual vulnerable to bruising.  

How Does Pristiq Cause Bruising? 

Serotonin plays a role in hemostasis. It is involved in the process where platelets join together to form a clot known as platelet aggregation. When this process starts, serotonin is released into the blood and it enhances the aggregation process (2). 

Pristiq is an SNRI and it blocks the transporter that carries serotonin into the platelets. A lack of serotonin in the platelets leads to increased risks of bruising (3).  Pristiq has a higher affinity for serotonin than norepinephrine, so it can also cause bruising (1). 

What does research suggest?

Many studies have been conducted to study the influence of antidepressants on platelets. Different clinical trials have reported that antidepressants decrease platelet activation and reduce the serotonin concentration in platelets (2). 

The occurrence of bruising with Pristiq is not widely reported in the literature. However, one case was reported where a patient developed a bruise on the right upper extremity after 10 weeks of treatment with Pristiq (4). 

In the above-mentioned study, Pristiq was associated with abnormalities in the coagulation cascade which resulted in acquired hemophilia. No other factor causing the bruise could be found and once the drug was discontinued, the issue was resolved (4). 

Although bruising is not a widely reported side effect of Pristiq, it can occur in some individuals because antidepressants influence platelet activation. Therefore bruising can occur with Pristiq and other antidepressants like citalopram and zoloft. 

Who Is More Susceptible to Bruising While Taking Pristiq? 

Bruising (ecchymosis) occurs when blood vessels beneath the skin break and blood leaks into the surrounding tissues (5). Some individuals are more likely to get bruises than others and taking Pristiq can further increase the risk. These individuals are as follows: 

Individuals with Bleeding Disorders: 

Certain bleeding disorders influence how the body forms clots or controls bleeding. Individuals can inherit or acquire these disorders and are at higher risk of bruising. Taking Pristiq further increases this risk. These disorders may include (5):

• thrombocytopenia
• von Willebrand disease
• hemophilia
• inherited platelet disorders
• inherited coagulation disorders 

Older Adults:

As we age, the skin becomes thinner and its ability to protect the blood vessels from injury decreases. Collagen production is also decreased in older adults (6). Thus, the risk of bruising in older adults is further exacerbated if they are taking Pristiq. 

Individuals taking certain medications:

Certain medications are associated with increased risks of bleeding. Concomitant use of these medications with Pristiq can increase the risks of bruising in individuals. These medications include (7):

• NSAIDs like diclofenac and ibuprofen 
• aspirin
• clopidogrel
• prasugrel
• vitamin-K antagonists
• heparin 

Warning Signs: When to Contact Your Doctor?

Different warning signs indicate potential bruising and bleeding complications while taking Pristiq. You must contact your doctor if you observe the following signs:

Unusual Appearance of Bruises: 

Unusually large bruises that quickly grow and spread over a large area are not normal. If you notice these characteristics in a bruise or experience frequent bruises, you must tell your healthcare provider. 

Unexplained Bruises: 

Bruises often occur when you experience a minor trauma or injury. If you observe bruises on your body without any reason, it indicates a complication and you should contact your healthcare provider. 

Other Symptoms: 

Symptoms like frequent nose bleeds or bleeding from gums, prolonged bleeding from cuts and wounds, low energy levels, and weakness may indicate a significant issue that requires medical attention. 

How to Manage Pristiq-Induced Bruising?

Here are some useful tips to avoid and manage Pristiq-Induced Bruising:

Take Preventive Measures: 

You should be aware of your surroundings so you don’t accidentally bump or collide. Use good lighting and organize your furniture such that it doesn’t come in your way when you walk. Avoid activities that may cause injury or use protective gear while engaging in these activities. 

Dietary Modifications:

Several nutrients like vitamin K and vitamin C can help you avoid bruising and heal the bruises while you are taking Pristiq. Vitamin K is important for blood clotting and vitamin C improves skin health. Therefore, make sure that your diet is rich in these nutrients.

Cold Compresses: 

Applying cold compresses to the bruises caused by Pristiq can help to reduce the swelling, pain, and inflammation. Do not apply ice directly to the bruise, instead cover it in a soft fabric. You can also use things like a bag of frozen peas for this purpose. 

What are some other side effects of Pristiq? 

Bruising is a rare side effect of Pristiq. Some common side effects of Pristiq include (1).

• nausea
• headache
• abdominal pain
• dizziness
• decreased appetite 

Understanding Bruising with Pristiq’s Use:

From my perspective, the research I have done indicates that Pristiq can cause bruising in some individuals although it is a rarely reported side effect. If you observe any unexplained bruises on your body while taking Pristiq, you must contact your healthcare provider. 

References