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 the right coordination and monitoring.

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.”

Subject: Guidance on Psychiatric Medications and Bleeding Disorders

Dear [Facility Contact / Prescriber Name],

Thank you for your thoughtful approach to managing my mental health treatment alongside my bleeding disorder. I wanted to share national guidance from the Medical and Scientific Advisory Council (MASAC) of the National Bleeding Disorders Foundation (Document 289, approved October 2024).

MASAC advises that individuals with bleeding disorders 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 person’s bleeding-disorder treatment team to help assess bleeding risk, weigh benefits, and identify any monitoring needs.

To help ensure that my care is safe and coordinated, I’d like to ask that your team communicate directly with my bleeding-disorder treatment team before starting or adjusting any psychiatric medications. They can provide input on bleeding risk, monitoring recommendations, and potential interactions with my current treatment plan.

I’ve attached the relevant excerpt from MASAC Document 289, as well as Appendix I, which lists examples of psychiatric medications that may affect coagulation. These resources can support your team in making informed, individualized decisions.

Thank you for supporting an approach that prioritizes both my mental and physical health through collaboration and shared communication between care teams.

Warm regards,
[Your Name]
[Your Phone / Email]
(optional) [Bleeding-Disorder Treatment Team Contact Info]