J Clin Pharmacol
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CLINICAL STUDIES

Antiplatelet Activity During Coadministration of the Selective Serotonin Reuptake Inhibitor Paroxetine and Aspirin in Male Smokers: A Randomized, Placebo-Controlled, Double-blind Trial

Nicole Kotzailias, MD, Toni Andonovski, MD, Alexander Dukic, MD, Victor L. Serebruany, MD and Bernd Jilma, MD

From the Department of Clinical Pharmacology, Medical University Vienna, Austria (Dr Kotzailias, Dr Andonovski, Dr Dukic, Dr Jilma); the Department of Neurology, Medical University Vienna, Austria (Dr Kotzailias); the Department of Anaesthesiology, Medical University Vienna, Austria (Dr Andonovski); and the Department of Medicine, Johns Hopkins University, Baltimore, Maryland (Dr Serebruany).

Depression is associated with an increased incidence of vascular events and develops after stroke and myocardial infarction. Beside potential clinical outcome benefits of selective serotonin reuptake inhibitors for vascular diseases, bleeding events were reported. We investigated whether paroxetine and aspirin synergistically inhibit platelet function. Paroxetine (20 mg/d) was administered over 18 days to 20 men in a randomized, placebo-controlled, crossover design. Aspirin (100 mg/d) was coadministered within the last 4 study days. Platelet function was assessed by the platelet function analyzer and by flow cytometry. Paroxetine prolonged epinephrine-dependent predictive index within 14 days (P < .02). Aspirin enhanced the predictive index (P < .004 vs baseline and P > .05 between periods). A trend toward decreased thrombin receptor-activating peptide–induced CD62P expression after paroxetine was further enhanced by aspirin treatment (P > .05 between periods). The combination of paroxetine and aspirin did not further inhibit platelet plug formation under high shear stress in male smokers.

Key Words: Selective serotonin reuptake inhibitor (SSRI) • aspirin • platelet function • platelet function analyzer (PFA-100) • randomized controlled trial

Address for reprints: Bernd Jilma, MD, Department of Clinical Pharmacology, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.


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