Whereas leucocytopenia is reported to be a relatively frequent side-ef
fect of treatment with tricyclic and tetracyclic antidepressants and a
typical neuroleptic agents, isolated thrombocytopenias are rare. To ou
r knowledge there are no reports of thrombocytopenia in connection wit
h the tetracyclic antidepressant maprotiline. This report describes th
e case of a 53-year-old female patient with neurotic depression and an
initially unsuspected chronic idiopathic thrombocytopenic purpura (IT
P). Following previous treatment with an angiotensin-converting enzyme
inhibitor, cilazapril, and an estrogen derivative, the patient develo
ped an episode of the ITP after beginning treatment with maprotiline.
The possible aetiology and the course of the illness are discussed.