Some mental health medications can affect how the blood clots (known as coagulation). This can understandably cause concern for behavioral-health or substance-use treatment facilities caring for someone with a bleeding disorder. While caution is appropriate, it’s also important to know that these medications can still be used safely in people with bleeding disorders with coordination of your provider teams and appropriate monitoring. Talk with both your mental health and bleeding disorder treatment teams to determine a plan that supports your mental and physical health.

According to national guidance from the National Bleeding Disorders Foundation’s Medical and Scientific Advisory Council (MASAC) in Document 289 (approved October 2024):

“Individuals with bleeding disorders admitted to inpatient or residential behavioral-health facilities should be prescribed the most clinically appropriate psychiatric medications, with individualized consideration of both psychiatric and hematologic risks and benefits.”

When possible, prescribing decisions should include consultation with the bleeding disorder treatment team, who can help:

• Assess potential bleeding risks

• Identify any monitoring that may be helpful

• Collaborate on a plan that supports both mental and physical health

This teamwork ensures that individuals with bleeding disorders receive safe, effective, and coordinated care without delay.

Reassuring Facilities About Mental Health Medications and Bleeding Risk

• “I understand your team may be concerned about psychiatric medications that can affect bleeding risk. That’s a valid issue, and one my treatment team can help with.”

• “Some mental health medications can impact coagulation, but this shouldn’t prevent me from receiving the mental health treatment I need.”

• “This isn’t just my opinion — it’s based on guidance from the national experts in bleeding disorders, the National Bleeding Disorders Foundation’s Medical and Scientific Advisory Council (MASAC), Document 289 approved in October 2024.”

• “MASAC recommends that people with bleeding disorders receive the most appropriate psychiatric medications, with individualized consideration of both psychiatric and hematologic risks.”

• “I’d recommend involving my bleeding-disorder treatment team in the conversation. They can help assess bleeding risk, weigh benefits, and identify any monitoring needs before starting a new medication.”

• “With good communication between your team and mine, I can receive safe, effective care that supports both my mental and physical health.”

Send the following to the facility:

• Guidance on Psychiatric Medications and Bleeding Disorders: Personalize this email template to share relevant MASAC guidance on psychiatric medications for people with bleeding disorders.

• Medical and Scientific Advisory Council (MASAC) of the National Bleeding Disorders Foundation (Document 289, approved October 2024).