Abstract
Selective serotonin reuptake inhibitors (SSRIs) are a mainstay treatment for panic disorder, however a potential link to lower gastrointestinal bleeding (LGIB), particularly with Paroxetine, is unknown. We present a rare case of LGIB possibly caused by Paroxetine in a 35-year-old female with panic disorder. LGIB resolved after SSRI cessation, implying a possible causative relationship. We conducted a thorough clinical evaluation, including medical history, medication review, and endoscopic investigations. The patient complained of hematochezia, dizziness, and shortness of breath, which coincided with the start of Paroxetine for panic disorder. A colonoscopy indicated non-specific colitis, while an upper GI endoscopy revealed no abnormalities. LGIB resolved within a week of discontinuing Paroxetine, with no recurrence during following follow-up. This example adds to the little evidence pointing to a possible link between Paroxetine and LGIB in panic disorder. More research is required to understand the underlying mechanisms and confirm causality. While initially mysterious, this case eventually revealed the complicated connection between mental health, medicine, and physical manifestations. It emphasized the significance of alertness in monitoring potential side effects, the efficacy of alternative therapies such as CBT, and the importance of patient awareness in managing complex medical problems.