Case Report: Life-Threatening Fluoxetine-Linked Postoperative Bleeding Informed by Pharmacogenetic Evaluation

Area of Science:

• Pharmacology
• Clinical Medicine
• Surgical Oncology

Background:

• Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed for depression and anxiety.
• SSRIs can inhibit serotonin reuptake in platelets, potentially increasing bleeding risk.
• Platelet dysfunction is a known side effect associated with SSRI use.

Purpose of the Study:

• To report a case of severe postsurgical bleeding in a patient taking SSRIs.
• To investigate the potential link between SSRI use and significant bleeding complications.
• To underscore the importance of considering SSRI effects in surgical patients.

Main Methods:

• Case report of a 52-year-old patient.
• Description of severe postsurgical bleeding following panniculectomy.
• Review of patient's medication and clinical presentation.

Main Results:

• The patient experienced severe bleeding requiring blood transfusion after surgery.
• The bleeding event was potentially linked to SSRI medication.
• This case illustrates a significant adverse event associated with SSRI therapy.

Conclusions:

• SSRI-induced bleeding is often dose-dependent.
• Individual variations in drug metabolism (enzymes and transporters) significantly influence bleeding risk.
• Awareness of SSRI-related bleeding risks is crucial for surgical patient management.