Does Sertraline cause blood thinning? (3+ precautions)

In this article, we will discuss whether Sertraline is associated with blood thinning, what the research studies indicate regarding this side effect, precautions to take while using Sertraline, and what to do if you experience blood thinning with Sertraline. 

Does Sertraline cause blood thinning?

Yes, Sertraline may cause blood thinning in some individuals. Certain patients who already have stomach problems or a history of bleeding are at a higher risk of experiencing this side effect. Such patients need to be more cautious while using Sertraline (4).

What does research suggest?

According to research studies, Sertraline and other antidepressants may cause difficulties with blood clotting (9). It may make it harder for platelets in the blood to stick together and form clots, hence causing reduced platelet activity and longer bleeding times.

There is limited research to support the link between Sertraline dose and blood thinning. This side effect may be controlled by reducing Sertraline dose or it should be discontinued if bleeding persists. However, the risk of bleeding may vary from person to person due to differences in their physiological responses (1). 

If you experience bleeding issues while taking antidepressants like Sertraline, your doctor may examine you for having underlying platelet-related problems, or the type of antidepressant you are taking.

Antidepressants like Sertraline may alter blood clotting, but the extent of these alterations is not fully understood. There might also be underlying genetic factors that may cause blood thinning with Sertraline (2).

Sertraline may cause some common side effects of headaches, sleep disturbances, diarrhoea or constipation, sweating, dizziness, heartburn, fatigue and sexual side effects. In addition to these side effects, Sertraline may also increase the risk of gastrointestinal bleeding.

Sertraline may cause increased acid production in the stomach, leading to a higher chance of bleeding in the stomach or intestines. The risk of stomach bleeding may also increase when Sertraline is taken with certain other medications like NSAIDs or low-dose Aspirin, but only in patients who already have a history of stomach or bleeding disorders (3). 

What precautions should be taken while using Sertraline?

If you are using Sertraline with Aspirin, Warfarin, NSAIDs like Ibuprofen, or other blood thinning medications, you must be cautiously monitored by your doctor (6). Elderly patients, who are more prone to other side effects of SSRIs like Sertraline, may have a mild increased bleeding risk (5).

Patients who have a history of stomach problems or bleeding disorders are at a higher risk of bleeding. Before any surgery, your doctor may decide whether to continue Sertraline or discontinue it. They will consider the risks of stopping Sertraline leading to discontinuation syndrome, a return of depression symptoms, or even a relapse (7).

There may be a rare and serious side effect of anal pain and rectal bleeding if Sertraline is taken at higher doses; if you experience any such side effects, immediately report them to your doctor (8).

What to do if you experience blood thinning with Sertraline?

If you experience prolonged bleeding while on Sertraline, you should immediately inform your doctor. They may reduce the dosage or replace Sertraline with other antidepressants with reduced risks of bleeding, such as Venlafaxine, Fluvoxamine, Amitriptyline, Imipramine, and Mirtazapine (2).

If you have a history of bleeding or blood clotting disorders, your doctor will carefully monitor you while on Sertraline or other antidepressant treatments. If you experience abnormal bleeding while on Sertraline, your doctor may suggest certain laboratory tests to determine problems with blood clotting and platelets. 

Conclusion

In this article, we have discussed the blood thinning side effect of Sertraline. According to research studies, Sertraline and other antidepressants may affect blood clotting, causing prolonged bleeding.

You must be vigilant about any side effects while using Sertraline, especially when using it with other blood-thinning medications like Aspirin, Warfarin, or NSAIDs. Those who have a history of stomach problems or bleeding disorders and older people must be cautiously prescribed Sertraline with regular monitoring.

If you experience prolonged bleeding while taking Sertraline, immediately seek medical help. While Sertraline is effective for treating depression and other mental health conditions, it is essential to be aware of its potential side effects.  

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References

1.-

Eslami Shahrbabki M, Eslami Shahrbabaki A. Sertraline-related bleeding tendency: could it be dose-dependent? Iran J Psychiatry Behav Sci. 2014 Fall;8(3):81-3. PMID: 25780379; PMCID: PMC4359729. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359729/ 

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Ceylan ME, Alpsan-Omay MH. Bleeding induced by SSRIs. Eur Psychiatry. 2005 Dec;20(8):570-1. doi: 10.1016/j.eurpsy.2004.09.018. PMID: 16337893. Available from: https://pubmed.ncbi.nlm.nih.gov/16337893/ 

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Andrade C, Sandarsh S, Chethan KB, Nagesh KS. Serotonin reuptake inhibitor antidepressants and abnormal bleeding: a review for clinicians and a reconsideration of mechanisms. J Clin Psychiatry. 2010 Dec;71(12):1565-75. doi: 10.4088/JCP.09r05786blu. PMID: 21190637. Available from: https://pubmed.ncbi.nlm.nih.gov/21190637/ 

5.-

Quinn GR, Singer DE, Chang Y, Go AS, Borowsky LH, Udaltsova N, Fang MC. Effect of selective serotonin reuptake inhibitors on bleeding risk in patients with atrial fibrillation taking warfarin. Am J Cardiol. 2014 Aug 15;114(4):583-6. doi: 10.1016/j.amjcard.2014.05.037. Epub 2014 Jun 5. PMID: 25001151; PMCID: PMC5176251. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5176251/ 

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Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://pubmed.ncbi.nlm.nih.gov/31613469/ 

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Roose SP, Rutherford BR. Selective Serotonin Reuptake Inhibitors and Operative Bleeding Risk: A Review of the Literature. J Clin Psychopharmacol. 2016 Dec;36(6):704-709. doi: 10.1097/JCP.0000000000000575. PMID: 27684291; PMCID: PMC5093043. Available from: https://pubmed.ncbi.nlm.nih.gov/27684291/ 

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Hadinezhad P, Hosseini SH. Sertraline-induced rectal bleeding and anal pain (a rare case presentation). Caspian J Intern Med. 2022 Winter;13(1):136-138. doi: 10.22088/cjim.13.1.136. PMID: 35178220; PMCID: PMC8797819. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8797819/ 

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Mazaira S. Efectos adversos hematológicos de los psicofármacos [Haematological adverse effects caused by psychiatric drugs]. Vertex. 2008 Nov-Dec;19(82):378-86. Spanish. PMID: 19424521. Available from: https://pubmed.ncbi.nlm.nih.gov/19424521/ 

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