Differential Impact of Selective Serotonin Reuptake Inhibitors on Platelet Response to Clopidogrel: A Randomized, Double-Blind, Crossover Trial

SSRIs and other antidepressant medications constitute one of the most commonly prescribed drug classes that pharmacists will see in the community setting. When taken alone, any one of these medications can be a good treatment option for patients experiencing depression; however, these drugs can cause a patient who is taking multiple drugs  to experience significant interactions with his/her other medications. For this reason, it is crucial to know how the effects of other medications can be altered through this therapy.  This study analyzed the effects of two SSRIs (citalopram and fluvoxamine) on the blood thinning medication clopidogrel. These medications all work on the same CYP enzyme (CYP2C19)  and have opposing effects. Researches tested these medications on healthy individuals and found that fluvoxamine was the only drug that caused significant inhibition of clopidogrel action.

I think this is important to note because these medications are commonly utilized by patients and thus there is a high likelihood that they may be taken together. As pharmacists, we should be able to provide adequate care in response to possible drug-drug interactions. To do this, we have to be able to recognize when there could potentially be a problem in medication therapy. By taking the proper precautions when these situations arise, pharmacists will be more likely to help patients avoid adverse medical events associated to drug therapy methods.

2 thoughts on “Differential Impact of Selective Serotonin Reuptake Inhibitors on Platelet Response to Clopidogrel: A Randomized, Double-Blind, Crossover Trial”

  1. These findings are definitely interesting. I wonder why fluvoxamine would inhibit CYP2C19 so much more than citalopram, even though they are both SSRI’s. Logically, you wouldn’t think there would be that much of a difference within drugs of the same class. This bring up an important point that there are constantly new discoveries about medications, no matter how long they’ve been on the market. We as pharmacists constantly have to be life-long learners to keep up with the ever-changing developments.

    Just as an extra comment, I think it would be a cool follow-up experiment to see how other classes of antidepressants affect clopidogrel’s activity. Clearly if there’s that big of a difference within the same class, maybe there’s more out there yet to be found.

  2. I agree that it is important to know of this potential drug-drug interaction when we counsel patients, as the high degree of use of both of these drugs means there is a greater risk of concomitant use. I would be interested to see if this study will be expanded to cover a wider range of SSRIs and possibly even to other antidepressant drug classes. As pharmacists, I think it will be important to be able to educate other healthcare professionals of this potential interaction as well.

Leave a Reply