title: Visual hallucinations related to angiotensin-converting enzyme inhibitor use: case reports and review.
abstract: Four patients experienced visual hallucinations that appear to have been precipitated by lisinopril. Other cases of visual hallucinations have been reported with other angiotensin-converting enzyme (ACE) inhibitors. Older patients, particularly those with a history of either dementia or mild cognitive impairment, may be at higher risk. Hallucinations resolved within 1 to 30 days after cessation of ACE inhibitors. Development of visual hallucinations after initiation of ACE inhibitors should prompt discontinuation of therapy. Visual hallucinations have been reported in one case involving an ARB. Visual hallucinations have not been associated with direct renin inhibitors. Consideration should be given to use of alternative, unrelated antihypertensive drug classes.
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA. john.doane@hsc.utah.edu
authors.forename: John
authors.initials: J
authors.lastname: Doane
authors.forename: Barry
authors.initials: B
authors.lastname: Stults
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D060825:Cognitive Dysfunction / Q000453:epidemiology; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology; D005260:Female; D006212:Hallucinations / Q000139:chemically induced*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D017706:Lisinopril / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D012307:Risk Factors; D028761:Withholding Treatment
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D017706:Lisinopril
references.citation: Am J Hypertens. 1989 Apr;2(4):294-306
references.pmid: 2706094
references.citation: J Am Coll Cardiol. 2011 May 17;57(20):2037-114
references.pmid: 21524875
references.citation: Lancet Neurol. 2009 Feb;8(2):151-7
references.pmid: 19138567
references.citation: J Neurol Neurosurg Psychiatry. 1997 Jan;62(1):16-21
references.pmid: 9010394
references.citation: JAMA. 2005 Oct 19;294(15):1934-43
references.pmid: 16234500
references.citation: Am J Psychiatry. 1985 Jun;142(6):759-60
references.pmid: 3890566
references.citation: J Am Geriatr Soc. 2000 Nov;48(11):1533
references.pmid: 11083340
references.citation: N Z Med J. 1999 Mar 12;112(1083):83
references.pmid: 10210314
references.citation: J Clin Hypertens (Greenwich). 2011 Sep;13(9):667-75
references.pmid: 21896148
references.citation: Life Sci. 1996;59(21):PL331-6
references.pmid: 8937511
references.citation: Postgrad Med J. 1993 Mar;69(809):240
references.pmid: 8497445
references.citation: Cardiology. 1996 Nov-Dec;87(6):569-70
references.pmid: 8904688
references.citation: Arch Intern Med. 2009 Jul 13;169(13):1195-202
references.pmid: 19597068
references.citation: J Pharmacol Exp Ther. 1997 May;281(2):769-74
references.pmid: 9152384
references.citation: South Med J. 1989 Mar;82(3):402-3
references.pmid: 2538002
references.citation: Am J Psychiatry. 1985 Feb;142(2):270
references.pmid: 3882005
references.citation: Arch Intern Med. 2012 Mar 12;172(5):442-4
references.pmid: 22412114
references.citation: J Am Soc Hypertens. 2010 Mar-Apr;4(2):90-8
references.pmid: 20400053
references.citation: J Am Soc Hypertens. 2012 Sep-Oct;6(5):309-15
references.pmid: 22995799
references.citation: Patient Prefer Adherence. 2012;6:1-9
references.pmid: 22272064
references.citation: J Am Coll Cardiol. 2009 Apr 14;53(15):e1-e90
references.pmid: 19358937
references.citation: Isr Med Assoc J. 2001 Dec;3(12):963-4
references.pmid: 11794927