TY - JOUR
T1 - Combined duloxetine and benzodiazepine-induced visual hallucinations in prodromal dementia with Lewy bodies
AU - Rolma, Giacomo
AU - Jelcic, Nela
AU - Gnoato, Francesca
AU - Cecchin, Diego
AU - Cagnin, Annachiara
PY - 2013/11
Y1 - 2013/11
N2 - Objective: We describe a patient with prodromal dementia with Lewy bodies (DLB) presenting with drug-induced visual hallucinations (VHs). Case report: A 78-year-old woman complained of daytime recurrent VHs characterized by seeing her face and arms covered in fur and viewing moustaches on her daughter's face. VHs started a few days after the beginning of a combination therapy with duloxetine and lorazepam and ceased within 24 h after their discontinuation. Nonamnestic mild cognitive impairment with profound visual perception deficits and very mild extrapyramidal signs, with abnormal brain DaTscan single photon emission tomography, were present. Three years later, cognitive and neurological follow-up assessments supported the diagnosis of DLB. Conclusion: Perturbation of cerebral serotonergic tone induced by duloxetine, associated with reduced attentional control due to benzodiazepine use, may be the physiopathological substrate of transient VHs in prodromal DLB.
AB - Objective: We describe a patient with prodromal dementia with Lewy bodies (DLB) presenting with drug-induced visual hallucinations (VHs). Case report: A 78-year-old woman complained of daytime recurrent VHs characterized by seeing her face and arms covered in fur and viewing moustaches on her daughter's face. VHs started a few days after the beginning of a combination therapy with duloxetine and lorazepam and ceased within 24 h after their discontinuation. Nonamnestic mild cognitive impairment with profound visual perception deficits and very mild extrapyramidal signs, with abnormal brain DaTscan single photon emission tomography, were present. Three years later, cognitive and neurological follow-up assessments supported the diagnosis of DLB. Conclusion: Perturbation of cerebral serotonergic tone induced by duloxetine, associated with reduced attentional control due to benzodiazepine use, may be the physiopathological substrate of transient VHs in prodromal DLB.
KW - Attention
KW - Dementia with Lewy bodies
KW - Duloxetine
KW - Hallucinations
KW - Visual perceptual deficit
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U2 - 10.1016/j.genhosppsych.2013.02.005
DO - 10.1016/j.genhosppsych.2013.02.005
M3 - Article
C2 - 23523020
AN - SCOPUS:84887057327
VL - 35
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
SN - 0163-8343
IS - 6
ER -