Concerns Over Decreased Platelet Counts with SSRIs
I am a 20-year-old female, standing 5 feet tall, and I was diagnosed with Obsessive-Compulsive Disorder (OCD) in 2023. In January 2024, I started treatment with fluoxetine at a dosage of 20 mg, which was quickly raised to 40 mg. Following this increase, I've experienced some unusual skin symptoms, specifically tiny red dots beneath the surface that are subtle yet peculiar. Unlike the petechiae I have encountered previously, these spots seem to originate from the skin pores themselves, appearing more inflamed and noticeable than usual. I have been undergoing regular blood tests, all of which have revealed a consistently low platelet count along with a high mean platelet volume (MPV). My preliminary research suggests that this condition could point toward an increased turnover of platelets. Dealing with both OCD and health-related anxiety, I often find myself fixating on the possibility of having a serious illness such as leukemia. Although my physician has not expressed major concern regarding this issue, my platelet levels have seen a decline since September of the previous year, dropping from 146 µg/L to 131 µg/L just last week. Should I be worried about this situation? Could my medication be contributing to these changes?
Answers (1)
7/11/2025, 7:40:46 PM
OpenHealth AI
It's understandable to be concerned about changes in your health, especially with the combination of OCD and anxiety. Let's address your situation regarding the low platelet counts, potential medication effects, and the unusual skin symptoms you've mentioned.
Main Points:
- Fluoxetine and Platelet Counts: Fluoxetine (an SSRI) can sometimes affect blood components, but significant changes to platelet counts are not common.
- Skin Symptoms: The tiny red dots you describe might be related to the platelet count, but other skin conditions could also cause these symptoms.
- Monitoring and Anxiety Management: It's important to monitor your symptoms and still find ways to manage your anxiety regarding your health.
Explanation:
- Platelets are blood cells that help with clotting. A low platelet count, called thrombocytopenia, can occur due to various reasons, including medication side effects, bone marrow issues, or increased destruction of platelets.
- Fluoxetine itself can sometimes lead to mild changes in platelet function but is not typically known to cause significant drops in platelet counts. However, your doctor would monitor for any adverse effects.
- The appearance of red dots could indicate a skin issue possibly linked to your platelet levels, inflammation, or even another benign skin condition.
Next Steps:
- Monitor Symptoms: Keep an eye on any changes in your symptoms, especially if the spots increase in number, size, or if you experience any additional symptoms like bleeding or bruising.
- Document Changes: Consider maintaining a symptom diary that includes when the spots appear, any associated activities, medications taken, or dietary changes. This can be valuable information for your next doctor’s visit.
- Discuss Concerns with Your Doctor: Since you seem worried about the platelet counts and skin symptoms, it’s worthwhile to bring this up with your healthcare provider. Ask them if the current low platelet levels are a concern in your case and whether any further testing is needed. Discuss how fluoxetine might affect you.
- Manage Anxiety: Techniques such as mindfulness, meditation, or therapy focused on CBT (Cognitive Behavioral Therapy) may help address your health anxiety and OCD symptoms.
It's great that you're proactive about your health. Monitoring and communicating openly with your healthcare provider can help ease your concerns and guide you towards the best management plan. If you have specific fears or further questions, feel free to reach out!
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