An emergency tracheotomy in case of airway compromise after post-operative bleeding associated with the use of an antidepressant
Selective serotonin reuptake inhibitors block the uptake of serotonin into thrombocytes. One of the functions of serotonin in thrombocytes is to promote platelet aggregation. When serotonin levels are depleted after several weeks of treatment, the altered platelet function leads to increased risk of abnormal bleeding. In patients taking a combination of a selective serotonin reuptake inhibitor and a non-steroidal anti-inflammatory drug, the risk of abnormal bleeding is thought to be even higher. A case is reported of abnormal bleeding after treatment in the oral cavity, associated with simultaneous use of a selective serotonin reuptake inhibitor and a non-steroidal anti-inflammatory drug. A large haematoma in the floor of mouth caused airway compromise which necessitated an emergency tracheotomy. Until greater insight is achieved by means of additional research, increased attentiveness for these patients seems to be called for and extra care should be employed. Additional haemostatic measures could be considered.