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Auditory hallucinations in an elderly patient: case report A 77-year-old woman developed auditory hallucinations during treatment with paroxetine and trazodone [routes not stated; therapeutic indications not clearly stated]. The woman was admitted for treatment of hypochondriasis with the misuse of hypnotic agents; minor brain atrophy was noted following cranial MRI. She started receiving paroxetine 20mg daily, quetiapine, brotizolam and flunitrazepam, with symptom improvement after 2 weeks. Her insomnia persisted, and flunitrazepam was subsequently replaced by trazodone 50mg daily. Within a few days, she reported hearing her son and grandson calling for her but said that she was unable to find them. Trazodone was withdrawn. Risperidone was initiated, with a dosage increase after 1 week. The woman’s auditory hallucinations continued for a further 3 weeks until paroxetine was withdrawn. Her risperidone dosage was reduced and quetiapine was withdrawn. No hallucination recurrence was noted, and she was subsequently discharged. Author comment: "[T]he auditory hallucinations disappeared immediately after paroxetine was discontinued. It is surmised that her hallucinations were induced by paroxetine." However, "trazodone has a serotonin reuptake inhibitory action, and so our patient’s auditory hallucinations might have been triggered by the additional medication of trazodone". Shimizu S, et al. Auditory hallucinations associated with clinical dosage of paroxetine: A case report. Psychiatry and Clinical Neurosciences 64: e666-667, No. 6, Dec 2010. Available from: URL: http://dx.doi.org/10.1111/ 803048084 j.1440-1819.2010.02141.x - Japan

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Reactions 22 Jan 2011 No. 1335