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Dr. Bob is Robert Hsiung, MD,
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Posted by JaneJ68 on July 28, 2003, at 19:16:48
Hi,
I was diagnosed with a DVT a few days ago and put on heparin and coumadin. They're about to take me off the heparin, but I'll likely need to be on the coumadin for a while. I've been feeling extremely anxious lately, definitely in part because of the blood clot (and fear of a pulmonary embolism), but I also think I need something for my anxiety in general. My GP prescribed Zoloft and told me there are no contraindications between Zoloft and Coumadin/Warfarin. However, in doing some research on my own, I've come across some things that seem to indicate there are. At the least that Zoloft can increase the affect of the Coumadin (in which case I guess the idea would be to lower the coumadin dosage?). Anyway, is anyone else out there on both coumadin and zoloft? Does anyone know anything about the safety of this combination? She didn't want to put me on anything potentially addictive, such as Ativan. But would there be a better drug combination? I always thought zoloft was for depression, not anxiety, but she said it's prescribed for both. Maybe I should be going to a psychiatrist for this, huh?
Thanks,
Jane
Posted by BekkaH on July 28, 2003, at 22:17:28
In reply to Zoloft/Coumadin, posted by JaneJ68 on July 28, 2003, at 19:16:48
Hi Jane,
You are absolutely right. Your doctor should know that serotonin affects platelet aggregation. Over the past few years, I have come across several articles about the risk of bleeding, especially GI (gastrointestinal) bleeding, in patients who are on SSRI's (serotonin reuptake inhibitors) like Zoloft. That risk is heightened for patients on anticoagulants such as Coumadin and Heparin. I am not a physician, but if I were you, I would rather lower the Zoloft dosage than the Coumadin. In fact, I would probably taper off of the Zoloft and replace it with an antianxiety agent such as low dose Klonopin, at least until your medical condition is stabilized. You should NOT tamper with your Coumadin dose by yourself. Don't lower the anticoagulant dose without discussing this with a KNOWLEDGEABLE physician.
Bekka
This is the end of the thread.
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