Some psychiatric medications may have potential impacts on coagulation, which can raise important concerns for facilities treating individuals with bleeding disorders. While caution is appropriate, this should not delay or prevent access to necessary mental health treatment.

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 mental health 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 to assess any relevant risks and monitoring needs. A collaborative, patient-centered approach ensures that individuals receive safe, coordinated care that supports both their mental and physical health.

Reassuring Facilities About Mental Health Medications and Coagulation

• "I understand your team may be concerned about the use of psychiatric medications that can affect bleeding risk—that’s a valid issue, and one we’re happy to help you navigate."

• "Some mental health medications can impact coagulation. But this shouldn’t prevent someone from receiving the mental health treatment they need."

• "This guidance comes directly from the national experts in bleeding disorders—NBDF’s Medical and Scientific Advisory Council (MASAC)—in Document 289, approved in October 2024."

• "MASAC recommends that individuals with bleeding disorders be prescribed the most appropriate psychiatric medications, with individualized consideration of both psychiatric and hematologic risks."

• "We recommend looping in the bleeding disorder treatment team when possible, so we can help assess bleeding risk, weigh benefits, and identify any monitoring needs before starting a new medication."

• "With proper coordination between your team and ours, we can ensure the patient receives safe, effective care that supports both their mental and physical health."

Send the following to the facility:

• MASAC Guidance on Mental Health Medications: Personalize this email template to introduce specific guidance on the use of mental health medications that may affect bleeding risk.

• Guidance on Medications with Potential Impact on Coagulation: To support clinical decision-making and ease concerns about prescribing psychiatric medications to individuals with bleeding disorders, send the following:

  • Relevant excerpt from MASAC Document 289 (Approved October 2024) this excerpt addresses the use of mental health medications with potential coagulation effects.

  • Appendix I to MASAC Document 289 – This appendix outlines examples of psychiatric medications that may affect coagulation and can help prescribers make informed, individualized decisions.