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Mahdanian AA, Looper KJ, Bacon SL, et al. Serotonergic antidepressants and increased bleeding risk in patients undergoing breast biopsy. Ther Adv Psychopharmacol. 2015;5(6):332-8doi: 10.1177/2045125315612014.
Mahdanian, A. A., Looper, K. J., Bacon, S. L., Mesurolle, B., Meterissian, S. H., & Rej, S. (2015). Serotonergic antidepressants and increased bleeding risk in patients undergoing breast biopsy. Therapeutic advances in psychopharmacology, 5(6), 332-8. https://doi.org/10.1177/2045125315612014
Mahdanian, Artin A, et al. "Serotonergic antidepressants and increased bleeding risk in patients undergoing breast biopsy." Therapeutic advances in psychopharmacology vol. 5,6 (2015): 332-8. doi: https://doi.org/10.1177/2045125315612014
Mahdanian AA, Looper KJ, Bacon SL, Mesurolle B, Meterissian SH, Rej S. Serotonergic antidepressants and increased bleeding risk in patients undergoing breast biopsy. Ther Adv Psychopharmacol. 2015 Dec;5(6):332-8. doi: 10.1177/2045125315612014. PMID: 26834966; PMCID: PMC4722505.
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Ther Adv Psychopharmacol. 2015 Dec;5(6):332-8. doi: 10.1177/2045125315612014.

Serotonergic antidepressants and increased bleeding risk in patients undergoing breast biopsy.

Therapeutic advances in psychopharmacology

Artin A Mahdanian, Karl J Looper, Simon L Bacon, Benoit Mesurolle, Sarkis H Meterissian, Soham Rej

Affiliations

  1. Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, QC, Canada Cedars Breast Clinic, McGill University Health Centre, Montreal, QC, Canada.
  2. Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, QC, Canada.
  3. Montreal Behavioral Medicine Centre, Hopital du Sacré-Cœur, Montreal, QC, Canada.
  4. Cedars Breast Clinic, McGill University Health Centre, Montreal, QC, Canada.
  5. Geri-PARTy Research Group, Department of Psychiatry, Jewish General Hospital, McGill University, Montreal, QC, Canada, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Baycrest Avenue, Room FG-08, M4N 3M5, Canada.

PMID: 26834966 PMCID: PMC4722505 DOI: 10.1177/2045125315612014

Abstract

OBJECTIVES: Recent investigations have shown that serotonergic antidepressant (SAd) use may increase the risk of peri-operative bleeding events. Our objective was to evaluate the possibility of a similar association in patients undergoing radiologic breast biopsies.

METHODS: We used data from 3890 patients undergoing 6300 biopsy procedures between January 2011 and October 2014 in the Breast Clinic of McGill University Health Centre, Montreal, Canada. In this case-control study, cases were patients reported to have abnormal bleeding during their biopsy by board-certified radiologists. A control group of nonbleeders was selected using matching according to age and type of biopsy. The correlation between abnormal bleeding and SAd use was assessed using bivariate and multivariate statistical analyses.

RESULTS: There were 97 patients with abnormal bleeding and 137 matched controls; 10 bleeders (cases) were on SAds (7 citalopram, 3 paroxetine) while only 1 nonbleeder (control group) was on a SAd (low-dose sertraline, 25 mg/day). SAds were significantly associated with increased bleeding risk (10.3% versus 0.7%, Fisher's Exact p = 0.001). Moreover, after adjusting for confounding factors (age, type of biopsy, size of biopsy, needle caliber, pathology result and nonsteroidal anti-inflammatory drug use, multivariate logistic regression confirmed that SAds were associated with elevated bleeding risk (16.2, 95% confidence interval 1.87-140.1, p = 0.01).

CONCLUSIONS: This is the first study demonstrating increased bleeding events in breast biopsy patients using SAds. Clinicians should be aware that SAds may be associated with peri-operative bleeding risk, even in relatively minor procedures such as breast biopsies.

Keywords: bleeding; breast biopsy; serotonergic antidepressants

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