Venlafaxine-induced psychotic symptoms

Area of Science:

• Psychiatry
• Pharmacology
• Neuroscience

Background:

• Venlafaxine is a Serotonin Norepinephrine Reuptake Inhibitor (SNRI) antidepressant.
• It inhibits serotonin and norepinephrine reuptake; higher doses also inhibit dopamine reuptake.
• Dopamine reuptake inhibition by venlafaxine is a rarely reported cause of psychosis.

Purpose of the Study:

• To report a case of venlafaxine-induced psychosis.
• To highlight the potential adverse effect of dopamine blockade by venlafaxine.

Main Methods:

• Case report of a 32-year-old male with social phobia.
• Administration of venlafaxine 150 mg/day.
• Observation of psychotic symptoms (delusions of persecution).
• Response to venlafaxine withdrawal and antipsychotic treatment.

Main Results:

• The patient experienced delusions of persecution on two separate occasions when treated with venlafaxine.
• Symptoms resolved after discontinuing venlafaxine and a brief course of antipsychotics.
• No recurrence of delusions when switched to escitalopram.

Conclusions:

• Venlafaxine, particularly at higher doses, may induce psychotic symptoms due to dopamine reuptake inhibition.
• This case underscores the importance of considering venlafaxine's dopaminergic effects in patients developing psychosis.
• Alternative antidepressants like escitalopram may be suitable for patients experiencing such adverse effects.