Serotonin Surge: Intravenous Escitalopram as a Rare Cause of Drug-Induced Aplastic Anaemia

Escitalopram is a commonly prescribed medication that has infrequently been implicated in drug-induced thrombocytopenia (DITP) but has never been associated with aplastic anaemia in the literature. We present an extremely rare case of hypoproliferative pancytopenia due to self-administered intravenous (IV) injection of escitalopram. The crux of this case is the unusual trilineage cytopenia. Our patient was managed with steroids and supportive care with subsequent clinical and blood count recovery. This case sheds light on this uncommon but important association. LEARNING POINTS: Escitalopram is an uncommon medication that could lead to drug-induced aplastic anaemia. The adverse effects of escitalopram on red cell, white cell and platelet counts may be exacerbated on intravenous administration of the medication. Timely diagnosis is vital for the effective treatment of severe aplastic anaemia, avoiding complications and preventing recurrence.