US EPA

2250517 

Technical Report 

Propranolol induced hallucinosis 

Horn, JR; Rylander, ML; Hicks, HM 

1982 

IPA/83/505058 

Pharm 

REF 24 

464-468 

eng 

IPA COPYRIGHT: ASHP The literature on propranolol induced hallucinosis is reviewed, and 2 patients with visual and tactile hallucinations associated with propranolol administration are presented. The first patient was a 71-yr-old woman who was receiving propranolol hydrochloride 120 mg 4 times a day for hypertension; she had taken this dose of propranolol for several yr. Two months following cataract surgery, the patient complained of visual hallucinations. The symptoms did not resolve during the following month, and the patient was hospitalized. At this point, she had also developed tactile and olfactory hallucinations. Propranolol was discontinued by tapering the dose over days 2-14 of hospitalization, and the patient's hallucinations subsided by the fifteenth day of hospitalization. The second patient was a 64-yr-old woman hospitalized for acute pancreatitis; initial medications included digoxin, disopyramide, and nitroglycerin. On the second hospital day, hydralazine hydrochloride, 25 mg every 8 hr, and propranolol hydrochloride, 20 mg every 8 hr, were added to the regimen because of elevated blood pressure; the doses of the 2 drugs were increased to 50 mg every 6 hr and 40 mg twice a day, respectively, 3 days later. On the sixth hospital day, the patient became confused, disoriented, and combative and complained of visual and tactile hallucinations. Propranolol and hydralazine were discontinued, and the patient's symptoms resolved within 2 days.