Posted by Sunnely on November 27, 2000, at 1:06:57
In reply to Nosebleeds and Neurontin/Seroquel/Effexor, posted by Erinn on November 26, 2000, at 19:07:11
> Has anyone experienced nosebleeds while taking these drugs? This is something new for me - I have never had this problem in the past.
++++++++++++++++Hi Erinn,
If indeed this is due to your meds, not sure which is the culprit but will bet on either Effexor or Neurontin, or both.
During clinical trials of Neurontin, it was reported to cause (infrequently) epistaxis (nose bleeding). It was also reported to cause easy brusing during physical trauma and infrequently, thrombocytopenia (low platelet count) and prolonged bleeding time.
Effexor, although not an SSRI, is also a serotonin booster (and norepinephrine, at higher doses). SSRIs have been reported to cause some forms of bleeding difficulties such as abnormal menstrual bleeding, gastrointestinal bleeding, bruising, and nose bleeding. The mechanism as to how this occurs seems related to the SSRIs' effect on serotonin. Under normal circumstances, platelets (blood particles responsible for clotting) release serotonin at the site of blood vessel tears, leading to further platelet aggregation and vasodilation (blood vessels enlarge). This permits sealing of the tear stopping the bleeding. It appears that the SSRIs block the reuptake of serotonin into the platelets which lead to decreased serotonin to be released by the platelets into the site of bleeding.
The following is a case report of increased bleeding tendency due to Effexor. A 19-year-old woman developed spontaneous bruising and 3 ecchymoses on her arms (some form of bleeding under the skin) after beginning Effexor, 50 mg twice a day. She had no personal or family history of any bleeding disorder nor any other medical condition. Her clotting factors and platelet count were noted to be within normal limits. Once Effexor was stopped, her ecchymoses and bruising resolved over 10 days.
BTW, are you regularly taking other meds (e.g., ibuprofen, aspirin, vitamin E)? Herbs (e.g., the "G" herbs such as ginkgo, ginseng, garlic, ginger, guarana; also, feverfew, licorice, dong quai)? Family history of bleeding tendencies? How is the humidity in your residence? Too dry air can make one prone to nose bleed.
You should inform your doctor about this problem. May need to hold your meds to determine if they are the culprit. (Don't stop your meds abruptly without doctor's advice.) Of course, there is the risk of relapse of your psychiatric condition. You may need to have some lab tests, too (e.g., complete blood count including platelets, PT, PTT, INR).
poster:Sunnely
thread:49459
URL: http://www.dr-bob.org/babble/20001115/msgs/49479.html