The Tolerability of Oral-Loaded Valproate After Remission of Acute Mania in Japanese Patients With Bipolar Disorder

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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.

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