Preferences help
enabled [disable] Abstract
Number of results
2018 | 18 | 1 | 19–24
Article title

Platelet count in elderly patients with unipolar depression – case control analysis

Title variants
Liczba płytek krwi u pacjentów w podeszłym wieku z depresją jednobiegunową – analiza typu case control
Languages of publication
Aim: While the effect of antidepressants on platelet functions is relatively well studied, there are few studies comparing platelet parameters, such as platelet count, between elderly patients with unipolar depression and non-depressed elderly subjects. Therefore, the aim of the study was to determine if there are differences in platelet count in elderly patients with unipolar depression (DEP) compared with non-depressed elderly patients (nonDEP) using case-control analysis. Methods: We measured platelet count in 582 (DEP: n = 291, nonDEP: n = 291) Caucasian in-patients aged ≥60. The mean age of the study subjects was 77.2 years, there were 243 (83.5%) women in both study groups. Results: The mean platelet count was significantly (p = 0.02) lower in the DEP group (241.6 ± 82.0) compared with the nonDEP group (263.6 ± 107.2). We also found that platelet count was not correlated with age. Conclusions: Compared with non-depressed controls, elderly patients with depression have decreased number of platelet cells. This, combined with the known effect of antidepressants on platelet agreeability, may translate into an increased risk of bleeding complications in the course of antidepressive treatment in elderly patients. Careful monitoring of platelet parameters is therefore recommended in the clinical population of elderly depressed patients.
Cel: O ile wpływ leków przeciwdepresyjnych na funkcje płytek krwi jest stosunkowo dobrze zbadany, o tyle niewiele jest badań porównujących parametry płytek krwi (takie jak liczba płytek krwi) u osób w podeszłym wieku z depresją jednobiegunową i bez depresji. Celem badania było określenie, czy istnieją różnice w liczbie płytek u pacjentów w podeszłym wieku z depresją jednobiegunową (DEP) w porównaniu z pacjentami w podeszłym wieku (nonDEP), za pomocą metody analizy case control. Metody: Oceniono liczbę płytek krwi u 582 (DEP: n = 291, nonDEP: n = 291) pacjentów rasy kaukaskiej w wieku ≥60 lat. Średni wiek badanych wynosił 77,2 roku, w obu grupach było 243 (83,5%) kobiet. Wyniki: Średnia liczba płytek krwi była istotnie statystycznie mniejsza (p = 0,02) w grupie DEP (241,6 ± 82,0) w porównaniu z grupą nonDEP (263,6 ± 107,2). Stwierdzono ponadto, że liczba płytek krwi nie korelowała z wiekiem. Wnioski: W porównaniu z grupą kontrolną u pacjentów w podeszłym wieku z depresją liczba płytek krwi była mniejsza. Fakt ten, w połączeniu ze znanym wpływem leków przeciwdepresyjnych na agregację płytek krwi, może przełożyć się na zwiększone ryzyko wystąpienia powikłań krwotocznych w trakcie leczenia przeciwdepresyjnego u pacjentów w podeszłym wieku. Zaleca się ostrożne monitorowanie parametrów płytek w populacji klinicznej u pacjentów w podeszłym wieku.
Physical description
  • Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Łódź, Poland
  • Department of Geriatrics, Medical University of Lodz, Łódź, Poland
  • Department of Geriatrics, Medical University of Lodz, Łódź, Poland
  • Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Łódź, Poland
  • Department of Medical Psychology, Medical University of Lodz, Łódź, Poland
  • Department of Geriatrics, Medical University of Lodz, Łódź, Poland
  • Ataoglu A, Canan F: Mean platelet volume in patients with major depression: effect of escitalopram treatment. J Clin Psychopharmacol 2009; 29: 368–371.
  • Balduini CL, Noris P: Platelet count and aging. Haematologica 2014; 99: 953–955.
  • Cameron HA, Phillips R, Ibbotson RM et al.: Platelet size in myocardial infarction. Br Med J (Clin Res Ed) 1983; 287: 449–451.
  • Canan F, Dikici S, Kutlucan A et al.: Association of mean platelet volume with DSM-IV major depression in a large community-based population: the MELEN study. J Psychiatr Res 2012; 46: 298–302.
  • Correll CU, Frederickson AM, Kane JM et al.: Metabolic syndrome and the risk of coronary heart disease in 367 patients treated with second-generation antipsychotic drugs. J Clin Psychiatry 2006; 67: 575–583.
  • Crum RM, Anthony JC, Bassett SS et al.: Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA 1993; 269: 2386–2391.
  • De Berardis D, Campanella D, Matera V et al.: Thrombocytopenia during valproic acid treatment in young patients with new-onset bipolar disorder. J Clin Psychopharmacol 2003; 23: 451–458.
  • De Clerck F, Somers Y, Mannaert E et al.: In vitro effects of risperidone and 9-hydroxy-risperidone on human platelet function, plasma coagulation, and fibrinolysis. Clin Ther 2004; 26: 1261–1273.
  • De Hert M, Detraux J, van Winkel R et al.: Metabolic and cardiovascular adverse effects associated with antipsychotic drugs. Nat Rev Endocrinol 2011; 8: 114–126.
  • Dietrich-Muszalska A, Rabe-Jablonska J, Nowak P et al.: The first- and second-generation antipsychotic drugs affect ADP-induced platelet aggregation. World J Biol Psychiatry 2010; 11: 268–275.
  • Greisenegger S, Endler G, Hsieh K et al.: Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke 2004; 35: 1688–1691.
  • Gurguis GN, Andrews R, Antai-Otong D et al.: Platelet α2-adrenergic receptor coupling efficiency to Gi protein in subjects with posttraumatic stress disorder and normal controls. Psychopharmacology (Berl) 1999; 141: 258–266.
  • Kario K, Matsuo T, Nakao K: Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haematol 1992; 14: 281–287.
  • Kiliçli-Camur N, Demirtunç R, Konuralp C et al.: Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit 2005; 11: CR387–CR392.
  • Lainé-Cessac P, Shoaay I, Garre JB et al.: Study of haemostasis in depressive patients treated with fluoxetine. Pharmacoepidemiol Drug Saf 1998; 7 Suppl 1: S54–S57.
  • Lazier K, Chow EW, AbdelMalik P et al.: Low platelet count in a 22q11 deletion syndrome subtype of schizophrenia. Schizophr Res 2001; 50: 177–180.
  • Lee J, Powell V, Remington G: Mean platelet volume in schizophrenia unaltered after 1year of clozapine exposure. Schizophr Res 2014; 157: 134–136.
  • Machlus KR, Thon JN, Italiano JE Jr: Interpreting the developmental dance of the megakaryocyte: a review of the cellular and molecular processes mediating platelet formation. Br J Haematol 2014; 165: 227–236.
  • Marc LG, Raue PJ, Bruce ML: Screening performance of the 15-item geriatric depression scale in a diverse elderly home care population. Am J Geriatr Psychiatry 2008; 16: 914–921.
  • Martin JF, Bath PM, Burr ML: Influence of platelet size on outcome after myocardial infarction. Lancet 1991; 338: 1409–1411.
  • Msaouel P, Lam AP, Gundabolu K et al.: Abnormal platelet count is an independent predictor of mortality in the elderly and is influenced by ethnicity. Haematologica 2014; 99: 930–936.
  • Musselman DL, Marzec UM, Manatunga A et al.: Platelet reactivity in depressed patients treated with paroxetine: preliminary findings. Arch Gen Psychiatry 2000; 57: 875–882.
  • Ordu S, Ozhan H, Caglar O et al.: Mean platelet volume in patients with dipper and non-dipper hypertension. Blood Press 2010; 19: 26–30.
  • Pathansali R, Smith N, Bath P: Altered megakaryocyte-platelet haemostatic axis in hypercholesterolaemia. Platelets 2001; 12: 292–297.
  • Piletz JE, Zhu H, Madakasira S et al.: Elevated P-selectin on platelets in depression: response to bupropion. J Psychiatr Res 2000; 34: 397–404.
  • Ragolsky M, Shimon H, Shalev H et al.: Suicidal thoughts are associated with platelet counts in adolescent inpatients. J Child Adolesc Psychopharmacol 2013; 23: 49–53.
  • Rodgers GM: Overview of platelet physiology and laboratory evaluation of platelet function. Clin Obstet Gynecol 1999; 42: 349–359.
  • Ross DW, Ayscue LH, Watson J et al.: Stability of hematologic parameters in healthy subjects. Intraindividual versus interindividual variation. Am J Clin Pathol 1988; 90: 262–267.
  • Segal JB, Moliterno AR: Platelet counts differ by sex, ethnicity, and age in the United States. Ann Epidemiol 2006; 16: 123–130.
  • Seidel A, Arolt V, Hunstiger M et al.: Major depressive disorder is associated with elevated monocyte counts. Acta Psychiatr Scand 1996; 94: 198–204.
  • Semiz M, Yücel H, Kavakçı O et al.: Atypical antipsychotic use is an independent predictor for the increased mean platelet volume in patients with schizophrenia: a preliminary study. J Res Med Sci 2013; 18: 561–566.
  • Serebruany VL, Gurbel PA, O’Connor CM: Platelet inhibition by sertraline and N-desmethylsertraline: a possible missing link between depression, coronary events, and mortality benefits of selective serotonin reuptake inhibitors. Pharmacol Res 2001; 43: 453–462.
  • Soares JC, Mallinger AG, Dippold CS et al.: Platelet membrane phospholipids in euthymic bipolar disorder patients: are they affected by lithium treatment? Biol Psychiatry 1999; 45: 453–457.
  • Sobocki P, Jönsson B, Angst J et al.: Cost of depression in Europe. J Ment Health Policy Econ 2006; 9: 87–98.
  • Song HR, Jung YE, Wang HR et al.: Platelet count alterations associated with escitalopram, venlafaxine and bupropion in depressive patients. Psychiatry Clin Neurosci 2012; 66: 457–459.
  • Thomassen R, Vandenbroucke JP, Rosendaal FR: Antipsychotic medication and venous thrombosis. Br J Psychiatry 2001; 179: 63–66.
  • Tohen M, Castillo J, Cole JO et al.: Thrombocytopenia associated with carbamazepine: a case series. J Clin Psychiatry 1991; 52: 496–498.
  • van Walraven C, Mamdani MM, Wells PS et al.: Inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding in elderly patients: retrospective cohort study. BMJ 2001; 323: 655–658.
  • Wagner DD, Burger PC: Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 2003; 23: 2131–2137.
  • Wysokiński A, Margulska A, Sobow T: Bleeding complications in the course of treatment with antidepressants in elderly patients. Curr Psychiatry Rev 2015; 11: 244–249.
  • Yetkin E: Mean platelet volume not so far from being a routine diagnostic and prognostic measurement. Thromb Haemost 2008; 100: 3–4.
  • Zornberg GL, Jick H: Antipsychotic drug use and risk of first-time idiopathic venous thromboembolism: a case-control study. Lancet 2000; 356: 1219–1223.
Document Type
Publication order reference
YADDA identifier
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.