Vortioxetine-Induced Bleeding Tendency in a Young Woman with Depression: A Case Report

Vortioxetine, which functions as a 5-HT3, 5-HT1D, and 5-HT7 antagonist, a 5-HT1A agonist, and a 5-HT1B partial agonist, is a recently launched antidepressant approved by the United States Food and Drug Administration for treating adult major depressive disorder. Although hematological adverse effects have been associated with antidepressants, massive bleeding is a rare but potentially life-threatening complication. In this case report, we present a young woman who experienced abnormal bleeding tendencies, with manifestations including tarry stools, ecchymosis, and massive uterine bleeding, while undergoing vortioxetine treatment. Bleeding tendency improved after discontinuation of vortioxetine, recurred upon re-challenging, and resolved again after discontinuing the medication. This case study highlights the importance of closely monitoring bleeding tendencies in patients undergoing vortioxetine treatment. Physicians should exercise caution and thoroughly review medication history, especially for patients presenting with unexplained bleeding.