Key result
Lisinopril and other ACE inhibitors linked to reversible visual hallucinations in 4 patients.
Why the study?
Visual hallucinations have been reported with ACE inhibitor use, particularly in older patients with dementia or mild cognitive impairment, but detailed case descriptions are limited.
Case Report (n=4)
ACE inhibitors such as lisinopril may cause reversible visual hallucinations, particularly in older patients with cognitive impairment.
Answers are grounded in this paper and cite their sources.
May prompt ACE inhibitor review for new visual hallucinations; case reports leave open causality and prevalence.
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.
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Doane et al. (2013) conducted a case report in Visual hallucinations (n=4). ACE inhibitors (lisinopril) was evaluated on Visual hallucinations. Lisinopril and other ACE inhibitors precipitated visual hallucinations in 4 patients, which resolved within 1 to 30 days after cessation of the medication.
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