Clomipramine as an alternative to selective serotonin reuptake inhibitors for patients at haemorrhagic risk.

DISEASE relapse prevention; DRUG efficacy; NOSEBLEED; POLYCYTHEMIA vera; FLUVOXAMINE; HYDROXYUREA; SEROTONIN antagonists; CLOMIPRAMINE; NASAL septal perforation; ASPIRIN; OBSESSIVE-compulsive disorder; SERTRALINE; MIDDLE age

A case study of 59-year-old male, with history of schizophrenia stable on Paliperidone 3 monthly depot and a history of OCD that responded well to Fluvoxamine but was selfceased due to recurrent epistaxis is presented. Topics include exmaines acute psychiatric inpatient ward with obsessive ruminations about past social interactions where he ‘replay conversations' in his mind incessantly.