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Did Pills Produce Paris' Puffy Punim?

Oct. 27 2008, Published 7:07 a.m. ET

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PARIS MOON Hilton's face before (left) and after (right) jail

Perhaps you noticed a certain puffiness in the face of Paris Hilton in the photos taken as she walked out of jail early Monday. We certainly did, and wondered if it might not be related to the still-mysterious "medical condition" that earned her an early but short-lived furlough.

Since Los Angeles sheriff Lee Baca has said that Hilton suffered from a "life-threatening" psychiatric problem, we asked psychiatrist Jerald H. Ratner what types of medications might result in "moon facies," M.D.-speak for puffy cheeks.

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"Anything that increases serotonin levels can cause secondary fluid retention, especially in women," Ratner says. That means common drugs used to treat depression, such as Prozac, Zoloft, and Paxil, are among the possible culprits.

Swelling could also be caused by a mood stabilizer, like lithium, which is used to treat bipolar disorder, or else by an anticonvulsant used like a mood stabilizer. Certain atypical antipsychotics could have a similar effect, adds Ratner.

One thing it's unlikely to be is a benzodiazepine, a drug used to treat anxiety. Although Hilton claims she was suffering from severe anxiety and panic attacks, Ratner says, "We don't really see swelling with those." However, he adds, antidepressants can be used to treat anxiety.

On the other hand, it could just be all that hand-delivered junk food she was scarfing down in lockup.

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