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Coagulation activation and fibrinolysis impairment are reduced in patients with anxiety and depression when medicated with serotonergic antidepressants
Author(s) -
Geiser Franziska,
Conrad Rupert,
Imbierowicz Katrin,
Meier Christian,
Liedtke Reinhard,
Klingmüller Dietrich,
Oldenburg Johannes,
Harbrecht Ursula
Publication year - 2011
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/j.1440-1819.2011.02241.x
Subject(s) - serotonergic , fibrinolysis , medicine , antidepressant , partial thromboplastin time , endocrinology , plasminogen activator , psychology , coagulation , serotonin , receptor , hippocampus
Aims: Anxiety disorders have been shown to be correlated with an activation of coagulation and impairment of fibrinolysis. The aim of the study was to assess whether medication with a serotonergic antidepressant, which has been associated with abnormal bleeding, may modify this effect. Methods: Thirty‐one anxiety patients, mostly with comorbid depression, and 31 healthy controls were included in the study. Group differences between anxiety patients medicated with a serotonergic antidepressant, patients without serotonergic antidepressant and controls were assessed for activated partial thromboplastin time, fibrinogen, factor VII, factor VIII, von Willebrand factor, von Willebrand ristocetin cofactor activity, prothrombin fragment 1 + 2, thrombin‐antithrombin complex, d ‐dimer, α2‐antiplasmin, plasmin‐α2‐antiplasmin complex (PAP), tissue plasminogen activator and plasminogen activator inhibitor. Intervening variables, such as age, sex, body mass index and smoking, were accounted for. Results: We found lower coagulation measures for fibrinogen ( P = 0.03) and plasminogen activator inhibitor ( P = 0.01), and higher levels of PAP ( P = 0.046) in patients with serotonergic antidepressant than in patients without serotonergic antidepressant. When controlling for smoking and body mass index, differences between the two groups were significant for PAP ( P = 0.02), von Willebrand ristocetin cofactor activity ( P = 0.02) and activated partial thromboplastin time ( P = 0.046). Coagulation scores were similar in patients with serotonergic antidepressant to those of healthy controls. Conclusions: Serotonergic antidepressants may counteract a procoagulant effect of anxiety and/or depression in anxiety patients.