A 78-year-old woman was suffering from severe depression after the death of her daughter four months earlier. In addition to her recent mood disorder, the patient also had a history of hypertension, tachycardia, chronic bronchitis and arthritis. Her medications include ramipril, ticlopidine, torsemide, propafenone, theophylline daily with acetaminophen and triazolam as needed. After the onset of depression, her physician prescribed sertraline 50 mg/day to help ameliorate the condition.
She was later switched from sertraline to venlafaxine 75mg/day due to reduced effectiveness, which was increased to 150 mg/day after four weeks. Ten days after her venlafaxine was increased to 150 mg, the patient presented with visual hallucinations and psychomotor agitation. She reported seeing intruders, children and small animals in her house at night. The patient had no prior history of hallucinations…
