Dose-dependent spontaneous ecchymotic lesions after use of escitalopram: case report

Selective serotonin reuptake inhibitors (SSRI) and escitalopram belonging to this group, are commonly used antidepressants for their low side-effect profiles. Despite their low side-effect profiles, there are numerous studies and case reports showing that SSRIs can cause bleeding abnormalities. We are presenting a case with depression diagnosis that is followed with escitalopram treatment, and where after raising drug dose from 10 mg/day to 15 mg/day large-scale spontaneous ecchymotic lesions are advanced in both arms of the patient; and when the dose was lowered to well tolerated 10 mg/day, ecchymotic lesions gradually declined. Our case is important because it suggests that ecchymotic lesions may occur after use of escitalopram, depending to drug dosage. So this finding supports studies where SSRIs were found to cause bleeding side effects that could develop due to drug dosage. Many assumptions have been put forward to explain the mechanisms by which SSRIs lead to bleeding abnormalities; however there is no consensus on the subject yet.