title: Trimethoprim-sulfamethoxazole-related hallucinations.
abstract: Although adverse drug reactions are a well-recognized cause of mental status changes in the elderly, antimicrobials are not often implicated. Trimethoprim-sulfamethoxazole-induced hallucinations in immune-competent patient with switching to nitrofurantoin and risperidone, without associated polypharmacy, have not been reported in the literature. In this case report, we present an 86-year-old Caucasian immune-competent female with major depressive disorder and insomnia who developed hallucinations when treated with two trimethoprim-sulfamethoxazole tablets (80 mg/400 mg) in every 12 hours (4 tablets daily) because of lower urinary infection. After trimethoprim-sulfamethoxazole discontinuation and switching to nitrofurantoin and risperidone, symptoms significantly improved.
authors.affiliation: Psychiatric hospital Ormoz, Department for Clinical Pharmacy, Ormoz, Slovenia. Electronic address: matejstuhec@gmail.com.
authors.forename: Matej
authors.initials: M
authors.lastname: Stuhec
mesh_terms: D000369:Aged, 80 and over; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications; D057915:Drug Substitution; D005260:Female; D006212:Hallucinations / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007121:Immunocompetence; D009582:Nitrofurantoin / Q000627:therapeutic use; D018967:Risperidone / Q000627:therapeutic use; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000150:complications / Q000188:drug therapy*
chemical_list: D000892:Anti-Infective Agents, Urinary; D014150:Antipsychotic Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D009582:Nitrofurantoin; D018967:Risperidone
keywords: Cooperation between clinical pharmacsit and psychiatrist; Geriatric case report; Psychiatric adverse effect; Safety of Trimethoprim-sulfamethoxazole; Switching to nitrofurantoin; Visual hallucinations and delusions