Paroxetine-associated hypereosinophilia may clinically resemble a panic attack.

Hypereosinophilia is asymptomatic but can induce organ damage, which may cause neurological system abnormalities. We recently encountered a 29-year-old woman with depressive episodes who had eosinophilia as well as hyperventilation attacks, tremor, insomnia, and arthralgia of extremities after receiving paroxetine treatment. In parallel with the decrease in paroxetine dose, eosinophil count decreased and the related symptoms improved. Because it is sometimes difficult to distinguish between psychiatric symptoms such as panic attack and eosinophilia-related symptoms, frequent hematologic examination is required for patients treated with paroxetine.