Massive Epistaxis and Subconjunctival Hemorrhage Due to Combination of Paroxetine and Limaprost Alfadex: A Case Report

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Sir: A patient presented to us having experienced a few days of massive epistaxis and hyposphagma (severe hemorrhage into the conjunctiva) while taking paroxetine. Pharmaceutical use was also notable for the peripheral vasodilator limaprost alfadex. To our knowledge, no such case has been reported in the literature. We believe the combination of paroxetine and limaprost alfadex led to the bleed.

Prim Care Companion J Clin Psychiatry 2007;9(3):240-241 [letter]