This article is freely available to all

Article Abstract

Because this piece has no abstract, we have provided for your benefit the first 3 sentences of the full text.

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.