Lower gastrointestinal bleeding and paroxetine use: two case reports.

Background: Selective serotonin reuptake inhibitors (SSRIs) have been associated with depletion of serotonin in platelets, and risk of bleeding. Objective: The main objective is to report the cases of two young males with no medical problems other than their psychiatric disorders presenting with lower gastrointestinal bleeding after paroxetine use. Method: We report two cases of lower gastrointestinal bleeding in young, healthy subjects, after the use of low-medium doses of paroxetine. Results: The scarce literature available suggests that SSRIs in general, and paroxetine in particular, increase the risk of lower gastrointestinal bleeding. Conclusion: SSRIs have been associated with upper gastrointestinal bleeding but they also appear to be associated with lower gastrointestinal bleeding. Careful monitoring is particularly advisable during the initial period of use. Prospective studies are warranted to confirm the relationship between SSRI use and lower gastrointestinal bleeding.