Serotonergic thrombocytopathy and its effects on platelets during orthopaedic surgery.

The serotonergic effects on platelet dysfunction (thrombocytopathy) can cause deficient hemostasis during orthopaedic surgery. Peripheral serotonin located within the granules of platelets assists in initial platelet aggregation. Selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs) are drugs used to treat a myriad psychological-related, mental-related, and psychosocial-related disorders. A correlation exists between low levels of peripheral serotonin and a bleeding diathesis during orthopaedic surgery. The relationship of excessive bleeding during orthopaedic surgery secondary to thrombocytopathy and low levels of serotonin caused by drugs that inhibit the reuptake of serotonin is presented.