Escitalopram and Intermenstrual Vaginal Bleeding: A Probable Association

A 21 year-old woman started experiencing intermenstrual vaginal bleeding on the 6th day of initiation of escitalopram treatment for major depression which ceased 1 day after she stopped taking the drug. On escitalopram rechallenge the patient re-experienced vaginal spotting which resolved after discontinuation. There are no published reports on intermenstrual vaginal bleeding associated with escitalopram, although there are pre and postmarketing data mentioning this adverse effect. Multiple cases of menstrual disorders and vaginal bleeding with other antidepressants had been reported previously. This case supports previous unpublished data indicating escitalopram as a potential cause of intermenstrual vaginal bleeding.