Ecchymosis Induced by Sertraline: A Case Report of a Rare Adverse Reaction

Abstract

INTRODUCTION: Sertraline, an SSRI, is widely prescribed for depression and other psychiatric disorders. Although generally well-tolerated, SSRIs can rarely cause bleeding complications due to their effect on platelet aggregation. This case highlights a rare but clinically significant presentation of sertraline-induced ecchymosis in the absence of predisposing factors, contributing to the limited literature on SSRI-associated bleeding events. CASE PRESENTATION: A 34-year-old woman presented with large ecchymotic lesions on both arms three weeks after initiating sertraline therapy. She had no history of trauma, bleeding disorders, or concurrent medications. Laboratory evaluations, including coagulation studies and platelet count, were within normal limits. Symptoms resolved after discontinuing sertraline. Causality assessment using the Naranjo adverse drug reaction scale suggested a probable link between sertraline and ecchymosis. CONCLUSION: This case underscores the importance of recognizing sertraline as a potential cause of unexplained bruising. Clinicians should maintain a high index of suspicion for rare SSRIinduced bleeding events to ensure timely diagnosis and management.