Escitalopram
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Haematuria and decreased platelet aggregation: case report A 14-year-old boy developed haematuria and decreased platelet aggregation during treatment with escitalopram for obsessive compulsive disorder (OCD). The boy presented with ablutomania. He was subsequently diagnosed with OCD, for which he started receiving escitalopram 5 mg/day [route not stated]. The dose of escitalopram was further uptitrated by 5 mg/week, to achieve a dose of 20 mg/day over 1 month. However, he remained under marked distress with a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) severity score of 28. Therefore, the dose of escitalopram was further increased to 30 mg/day for the subsequent 2 weeks, which led to a tangible improvement in his condition, along with a drop in his Y-BOCS score from severe to mild. However, he subsequently developed gross haematuria. After ruling out all other possible aetiologies, the haematuria was attributed to escitalopram. Haematological consultation recommended coagulopathy profile testing, wherein haematological parameters and liver function tests were found to be normal; however, multiple electrode aggregometry confirmed decreased platelet aggregation secondary to escitalopram [durations of treatment to reactions onsets not stated]. Therefore, the boy’s dose of escitalopram was reduced, and he started receiving aripiprazole. At 6-months follow-up, he remained in remission, and his Y-BOCS score improved to 9 [ADR outcomes not stated]. Naguy A, et al. Supramaximal Dose of Ecitalopram-Associated Hematuria in an Adolescent With Obsessive-Compulsive Disorder: A Case Report. Journal of Clinical 803514504 Psychopharmacology 40: 102-103, No. 1, Jan-Feb 2020. Available from: URL: http://doi.org/10.1097/JCP.0000000000001163
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Reactions 14 Nov 2020 No. 1830
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