Visual and auditory hallucinations with excessive intake of paroxetine

Department of Psychiatry, Juntendo University, Edo, Tōkyō, Japan
Psychiatry and Clinical Neurosciences (Impact Factor: 1.62). 11/2003; 57(5):548-9. DOI: 10.1046/j.1440-1819.2003.01163.x
Source: PubMed
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    ABSTRACT: Duloxetine is a serotonin-noradrenaline reuptake inhibitor that is effective in the treatment of major depressive disorder (MDD) and chronic pain. The safety of duloxetine has been shown by many previous studies. We report a patient who experienced visual hallucinations after taking duloxetine. The patient experienced insomnia and chronic somatic pain. He began taking duloxetine after a diagnosis of MDD and developed visual hallucinations after the duloxetine dose was increased. The hallucinations disappeared after the duloxetine dose was decreased and then stopped; the dose of quetiapine was increased as an alternative. The specific cause of the duloxetine-induced hallucinations is unclear. In addition to other prescription medications and possible interactions with duloxetine, increasing dopamine by blocking noradrenaline transporters or serotonergic neurotransmission function may contribute to the occurrence of hallucinations.
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    ABSTRACT: We report on rare side effects of paroxetine. A 67-year-old female patient who had been suffering from prolonged depression for over a year but had not received appropriate treatment was administered 20-mg paroxetine daily. However, the patient required hospital admission after 16 days because of behavioural disturbances and delusions that she was being chased by evil persons from a religious group. The delusions were ultimately confirmed to be serial nightmares and an oneiroid state. The nightmares gradually disappeared following discontinuation of paroxetine. The Adverse Drug Reaction Probability Scale showed a score of 6 (probable). Reports on paroxetine-induced nightmares are rare, and there is a possibility that, in this case, parexetine caused the nightmares in association with depression and assumed underlying brain dysfunction due to ageing.
    Psychogeriatrics 03/2012; 12(1):54-7. DOI:10.1111/j.1479-8301.2011.00382.x · 1.22 Impact Factor
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