Management of Sertraline-Induced Hallucinations

Drug Interactions and Risk Factors

The American Academy of Family Physicians recommends that other antidepressants, such as SSRIs and SNRIs, be used with caution when combined with sertraline due to the risk of serotonin syndrome 1
The American Academy of Family Physicians suggests that antipsychotics and anticonvulsants may also increase the risk of serotonin syndrome when combined with sertraline 1, 2
Patients with underlying neurodegenerative disorders, pre-existing psychiatric conditions, and renal or hepatic impairment are at increased risk of developing sertraline-induced hallucinations 2, 3

The American Academy of Family Physicians recommends that atypical antipsychotics, such as risperidone, olanzapine, and quetiapine, be used to control hallucinations and delusions in patients with mood disorders 2, 3
The American Academy of Family Physicians suggests that typical antipsychotics, such as haloperidol and fluphenazine, be avoided in elderly patients due to the risk of tardive dyskinesia 2, 3

The American Academy of Family Physicians recommends that elderly patients be started on the lowest effective dose of sertraline (25-50 mg/day) and monitored closely for hyponatremia and cognitive impairment 1