Does sertraline cause bruising? (3+ factors at play)

In this article, we will discuss whether sertraline can cause random bruising. We will also discuss some research studies and discuss factors that can contribute to this side effect while taking sertraline. We will also talk about what one should do if bruising occurs. 

Does sertraline cause bruising?

Sertraline may cause bruising in some individuals. However, it is not considered a common side effect. Sertraline-induced bruising or redness of the skin could be an allergic reaction to this antidepressant (1,2). 

So, if you’re trying sertraline out for the very first time and start to notice random bruises, redness, or itching on your skin, you should seek immediate medical attention. Although allergic reactions to sertraline are not frequently reported, it is still a possibility and should be ruled out promptly. 

If you are allergic to sertraline and your bruising is one of the signs of a reaction, seeking medical attention is important to manage your symptoms and ensure your safety. 

However, sertraline may cause bruising in people who are not allergic to it, as it can affect your bleeding time – which is also an important concern and should be discussed properly.

What does research suggest?

There is limited research on sertraline-induced bruising, but research studies have linked the two together. 

One study has indicated that sertraline and other SSRIs could be linked to skin-related side effects or cutaneous side effects in certain individuals, leading to symptoms like bruising, thinning, redness, and hair loss (3). 

The study further explained how these side effects can sometimes take a serious turn in susceptible individuals and can lead to life-threatening complications such as Stevens-Johnson syndrome (3). 

Some research studies have linked sertraline-induced bruising to the blood-thinning effects of this antidepressant (4). Research has shown that sertraline has a blood-thinning tendency that might increase as the dose increases (4). 

In severe cases, it can lead to haemorrhage and bruising, resulting in life-threatening bleeding complications (4). Some individuals, such as those with pre-existing bleeding disorders or those taking anticoagulants, are more susceptible to this effect. 

Another research study indicated that sertraline-induced increased bleeding tendency can become worse when taken with medications like non-steroidal anti-inflammatory drugs (NSAIDs) and should be managed in clinical settings (5). The concomitant use of these meds can also increase the risk of gastrointestinal bleeding.

What factors can contribute to bruising while taking sertraline?

Some factors can contribute to bruising while taking sertraline, including: (2)

• The dosage of sertraline may contribute to bruising. Higher doses could potentially cause more severe bruising, while lower doses may not cause this side effect.

• Some individuals may experience an allergic reaction to sertraline, leading to increased bruising. Any signs of an allergic reaction, such as skin rash or difficulty breathing, should be immediately reported to a healthcare professional.

• Pre-existing haematological disorders, such as clotting or bleeding disorders, can contribute to increased bruising while taking sertraline. Individuals with known haematological conditions should inform their healthcare provider before taking this antidepressant.

• The concurrent use of other medications, especially blood thinners or NSAIDs, can increase the risk of bruising

What other effects are linked to sertraline-induced blood thinning?

The effects of sertraline on blood thinning can affect people differently. Those with pre-existing bleeding disorders may experience heightened side effects, as the blood-thinning effect of sertraline can exacerbate the severity of bleeding even from minor wounds. 

It is also important to understand the association between sertraline-induced blood thinning and gastrointestinal (GI) effects. Acid reflux, a potential side effect of sertraline, can lead to damage to the stomach lining.

This is significant because the blood-thinning property of sertraline, when coupled with stomach lining damage, increases the risk of GI bleeding (4). This complication can become worse when sertraline is unknowingly taken with NSAIDs. (6)

This is why healthcare providers need to educate their patients who take antidepressants or blood thinners to avoid such interactions.

What to do if sertraline causes bruising? 

If you’re noticing random bruises appearing on your skin after taking sertraline, you should seek immediate medical attention. Even if you do not have any haematological disorder, your bruises should be evaluated. 

Some individuals could be allergic to sertraline or could be sensitive to skin-related side effects of this antidepressant. Such susceptible individuals develop symptoms that are not commonly reported, so proper monitoring is important to ensure the safety and efficacy of sertraline for your symptoms. 

If sertraline is not a good option for you and continues to cause bruising or other skin-related side effects, your doctor will consider alternative treatment options. 

As a pharmacist, I have come across many patients who dislike sertraline because of how this antidepressant made them feel when they used it. They often talk about how discontinuing sertraline was the best thing they did and how it could be an antidepressant from hell for certain individuals. 

However, sertraline has thousands of success stories for different conditions, such as depression, OCD, anxiety, etc., and it can be a life-saving drug for some people. 

The best way to ensure a safe and effective treatment with sertraline is to closely follow your doctor’s advice and not make any changes to your prescription without discussing it with your doctor first.

References 

1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689

2. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf

3. Krasowska D, Szymanek M, Schwartz RA, Myśliński W. Cutaneous effects of the most commonly used antidepressant medication, the selective serotonin reuptake inhibitors. J Am Acad Dermatol. 2007 May;56(5):848-53. doi: 10.1016/j.jaad.2006.10.020. Epub 2006 Dec 4. PMID: 17147971. https://pubmed.ncbi.nlm.nih.gov/17147971/

4. Eslami Shahrbabki M, Eslami Shahrbabaki A. Sertraline-related bleeding tendency: could it be dose-dependent? Iran J Psychiatry Behav Sci. 2014 Fall;8(3):81-3. PMID: 25780379; PMCID: PMC4359729. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359729/ 

5. Bixby AL, VandenBerg A, Bostwick JR. Clinical Management of Bleeding Risk With Antidepressants. Ann Pharmacother. 2019 Feb;53(2):186-194. doi: 10.1177/1060028018794005. Epub 2018 Aug 6. PMID: 30081645. https://pubmed.ncbi.nlm.nih.gov/30081645/ 

6. de Jong JC, van den Berg PB, Tobi H, de Jong-van den Berg LT. Combined use of SSRIs and NSAIDs increases the risk of gastrointestinal adverse effects. Br J Clin Pharmacol. 2003 Jun;55(6):591-5. doi: 10.1046/j.0306-5251.2002.01770.x. PMID: 12814454; PMCID: PMC1884264. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884264/