Frågedatum: 1994-11-07
RELIS database 1994; id.nr. 10399, DRUGLINE
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The question concerns a patient treated with Buspar (buspirone) 5 mg tid and Cipramil (citalopram)



Fråga: The question concerns a patient treated with Buspar (buspirone) 5 mg tid and Cipramil (citalopram) 20 mg bid. After about two weeks the patient developed bruises on the arms and legs, a condition referred to as Henoch-Schönlein purpura. Could any of the drugs have caused the bruises?

Sammanfattning: There are no data to refute that buspirone or citalopram affect could blood or skin in a way that resembles the symptoms of this patient.

Svar: Buspirone is an anxiolytic drug which is neither chemically nor pharmacologically related to benzodiazepines or other anxiolytic drugs. The mechanism of action is not fully understood. The most commonly reported side-effects are headache, gastrointestinal discomfort and dizziness (1).

Citalopram is an antidepressant which enhances serotoninergic neurotransmission through inhibition of neuronal serotonin reuptake. Nausea, vomiting, increased perspiration and dry mouth are examples of frequent side-effects (2).

A thorough literature search covering pharmacological handbooks and the databases Medline and Swedis did not reveal any information bruises or Henoch-Schönlein purpura to be connected with any of these drugs.

Thrombocytopenia was mentioned as a rare event during premarketing evaluation of buspirone reported in PDR (3). The WHO Adverse Drug Reaction register contains some reports concerning platelet, bleeding and clotting problems among patients treated with buspirone, including six trombocytopenia, one skin discolouration and two vasculitis. Whether the adverse effects were caused by buspirone remains unknown as the register does not contain any kind of evaluation. Contact with the manufacturers did not add any further information. As both drugs are quite new on the market this suspected adverse effect should in any case be reported. 1 Goa KL, Ward A: Buspirone: a preliminary review of its pharmacological properties and therapeutic efficacy as an anxiolytic. Drugs 1986; 32: 114-129 2 Milne RJ, Goa KL: Citalopram: a review of its pharmacodynamic and pharmacokinetic properties, and yherapeutic potential in depressive illness. Drugs 1991; 41: 450-477 3 Physicians´ Desk Reference (PDR)(USA)1993; 47th ed:

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