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PLATELETS AND WHOLE BLOOD

“Platelets contain approximately 99% of whole blood serotonin…”
Teodor T. et al. Selective Serotonin Reuptake Inhibitors (SSRIs): Measurement of Effect on Platelet Function Transl Res. 2008 March ; 151(3): 168–172

“Serotonin stored in platelets represents more than 99% of the total serotonin concentration in the human body.”
Renoux C. et al. Association of Selective Serotonin Reuptake Inhibitors With the Risk for Spontaneous Intracranial Hemorrhage JAMA Neurol. 2017;74(2):173-180

DEPLETION AT ONE WEEK

“Platelets are depleted of serotonin within the first week, …”
Dall, M. et al. An Association Between Selective Serotonin Reuptake Inhibitor Use and Serious Upper Gastrointestinal Bleeding Clinical Gastroenterology and Hepatology 2009;7:1314 –1321

DEPLETION AT ONE WEEK

“In addition, we found a particularly high risk associated with recent start of SSRI therapy. Platelets are depleted of serotonin within the first week …”
Dall, M. et al. An Association Between Selective Serotonin Reuptake Inhibitor Use and Serious Upper Gastrointestinal Bleeding Clinical Gastroenterology and Hepatology 2009;7:1314 –1321

DEPLETION AT TWO WEEKS

“Intraplatelet serotonin concentrations are decreased by up to 80% within 2 weeks after initiation of an SA (serotonergic agent [SSRI]).”
Schultz, J. et al. Serotonergic agents increase the incidence of gastrointestinal bleeds in patients with continuous-flow left ventricular assist devices The J of Heart and Lung Transplantation, Vol 35, No 6, June 2016

DEPLETION AT THREE WEEKS

“After 3 weeks of treatment (with fluoxetine) … the platelet 5-HT content was significantly reduced by about 90% of its original level.”
Wagner, A. et al. Effects of fluoxetine treatment of platelet 3H-imipramine binding, 5-HT uptake and 5-HT content in major depressive disorder Journal of Affective Disorders Volume 20, Issue 2, October 1990, Pages 101-113

DEPLETION BEYOND THREE WEEKS

“Depending on the dose and type of medication (SSRI), the platelet 5-HT (serotonin) level can drop to undetectable levels.”
Maurer-Spurej. E. The influence of selective serotonin reuptake inhibitors on human platelet serotonin Thromb Haemost 2004; 91: 119–28

“…serotonin enhances platelet activation induced by adenosine diphosphate and thrombin, and SSRIs can deplete serotonin (induce a hyposerotonergic condition) in platelets by up to 95 %.”
Gagne, J. et al. Selective Serotonin Reuptake Inhibitor Use and Perioperative Bleeding and Mortality in Patients Undergoing Coronary Artery Bypass Grafting: A Cohort Study An International Journal of Medical Toxicology and Drug Experience; Vol. 38, Iss. 11, (Nov 2015): 1075-1082

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