Psychiatry and Clinical Psychopharmacology

Menstrualirregularity due to venlafaxine

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S172-S172
Read: 13749 Published: 18 February 2021

B.A. is a 48 years old female patient. She is 63 kg and her BMI was calculated as 28. She had never had a psychiatric treatment. She has two children. She had never had a gynecological problem before she appealed to us. Her periods were normal. Her complaints were loss of appetite, loss of energy, loss of interest and concentration problems. Her MADRS score was 30 and Beck Depression Scale score was 31. We started to give her extended-release venlafaxine 75 mg per a day. 20 days after she began to use her drug, she appealed us because of her extended period and increased vaginal bleeding. She consulted to gynecologist. There was no gynecological problem. Her complete blood cell count was normal as were a series of tests for platelet aggregation. Her FSH and LH degrees were normal. After her 13 day long period her treatment was continued under control of a gynecologist. Her follow up period was the same with previous one. We stopped venlafaxine treatment. After discontinued the drug, her period got normal just before the medication. No reason was found for her period abnormalities. We suspected that venlafaxine might be the culprit. We found one published report describing vaginal bleeding associated with venlafaxine. In addition, several cases of menstrual irregularities have occurred with two other antidepressants: şuoxetine and bupropion. SSRI’s may reduce platelet aggregation by inhibiting serotonin reuptake. Venlafaxine is also inhibitor of serotonin reuptake. This mechanism may contribute to the impact of this drug on menstrual irregularity. This case report supports that venlafaxine may cause vaginal bleeding and we must be careful about using SSRI’s and SNRI’s patients with who may have risk factors for bleeding.

EISSN 2475-0581