Selective serotonin reuptake inhibitors related bleeding risk: case report and review of literature

Gastrointestinal bleedings are relevant side effects in patients during anticoagulant therapy for atrial fibrillation. Direct oral anticoagulants (DOACs) are less correlated with major bleeding events than vitamin K antagonists (VKAs), but concerns are present about the relative risk of gastrointestinal bleeding. Here we report the case of a patient with atrial fibrillation and dementia on DOAC treatment who developed a SSRI-associated thrombocytopenia with subsequent life-threatening bleeding. Physicians should be aware of the possible correlation between SSRI-induced thrombocytopenia and concomitant use of anticoagulant and/or antiplatelet drugs, thus preventing life-threatening bleedings.