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Letter to the Editor

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

Kiyomi Shinohara, MD; Yasumasa Okamoto, MD, PhD; Hiroaki Jitsuiki, MD, PhD; Hidehisa Yamashita, MD, PhD; Shigeru Morinobu, MD, PhD; and Shigeto Yamayaki, MD, PhD

Published: June 15, 2007

Article Abstract

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Sir: A patient presented to us having experienced a fewdays of massive epistaxis and hyposphagma (severe hemorrhageinto the conjunctiva) while taking paroxetine. Pharmaceuticaluse was also notable for the peripheral vasodilatorlimaprost alfadex. To our knowledge, no such case has been reportedin the literature.

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