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Serotonin-Affecting Antidepressant Use in Relation to Platelet Reactivity.
Joseph Grech1, Melissa Victoria Chan1,2, Chinedu Ochin3,4
1Population Sciences Branch, National Heart, Lung, and Blood Institute, Framingham, Massachusetts, USA.
Clinical Pharmacology and Therapeutics
|December 23, 2021
Summary
Antidepressants, especially those affecting serotonin, significantly inhibit platelet function. This study found no link between depression itself and altered platelet activity, suggesting medication effects are key.
Area of Science:
- Cardiovascular Disease
- Neuroscience
- Pharmacology
Background:
- Depression is a known risk factor for cardiovascular disease morbidity.
- Serotonin, a neurotransmitter implicated in depression, is present in platelets and weakly activates them.
- Understanding the interplay between depression, platelet function, and antidepressant use is crucial for cardiovascular health.
Purpose of the Study:
- To investigate the association between platelet reactivity, depression, and antidepressant (AD) use in a large population.
- To determine if ADs, particularly those targeting serotonin or norepinephrine, affect platelet function.
- To explore the relationship between depressive symptoms and platelet traits independent of medication.
Main Methods:
- Analysis of data from the Framingham Heart Study (n=3,140), including 563 antidepressant users and 681 aspirin users.
- Measurement of depression using the Center for Epidemiological Studies-Depression (CES-D) survey.
- Assessment of platelet reactivity across multiple agonists using five distinct assays, analyzed with linear mixed effects models.
Main Results:
- Significant associations were found between reduced platelet function and antidepressant use, especially with serotonin-affecting ADs.
- Specific findings include decreased epinephrine-induced aggregation, increased U46619 half maximal effective concentration, and altered adenosine diphosphate (ADP) aggregation and disaggregation.
- No significant associations were observed between platelet traits and depression itself; findings were consistent in an aspirin-taking subset.
Conclusions:
- Antidepressants, particularly serotonin-affecting ones, inhibit platelet function, likely through platelet serotonin depletion.
- This inhibition may explain how ADs increase bleeding risk and potentially decrease thrombosis risk.
- Depressive symptomatology, in the absence of medication, was not associated with altered platelet function in this study.
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