Reactions 1333 - 8 Jan 2011

Citalopram

Hallucinations and delusions: case reportA 27-year-old man developed hallucinations and

delusions during treatment with citalopram for combat-related post-traumatic stress disorder and associateddepression.

Soon after starting citalopram 20mg daily [route ofadministration not stated], the man began to experience anumber of psychotic symptoms. These symptoms included"cold tingling and numbness" to distal extremities and hisupper back, concentration difficulties, increased irritability,suspiciousness, non-bizarre hallucinations and paranoia.The symptoms worsened and became severe after day 4 ofcitalopram administration. The patient reported severeagitation and suspiciousness, saying "it felt like people werecoming to get me" and "it felt like my brain was on fire".Upon examination, the man was found to have significantparanoid delusions and hallucinations, with no symptomsof mania. His agitation appeared to increase with each doseof citalopram, and he described his mood as "aggravated".At times the man’s affect was inappropriate. He wasadmitted for inpatient psychiatric treatment.

Citalopram was discontinued and the man’s symptomsresolved within 48 hours. He was discharged as anoutpatient after 4 days.

Author comment: "Given the factors in this case, it wasfound to be a probable adverse drug reaction (ADR) was ascore of 5 using the Naranjo adverse drug reaction probabilityscale."Capaldi VF, et al. Citalopram-induced hallucinations and delusions in a youngadult. General Hospital Psychiatry 32: 648.e1-648.e3, No. 6, Nov-Dec 2010.Available from: URL: http://dx.doi.org/10.1016/j.genhosppsych.2010.07.008 -USA 803046913

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Reactions 8 Jan 2011 No. 13330114-9954/10/1333-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved