A Case Report of Paranoid Delusion With Venlafaxine Use

This case report described an 85-year-old male patient who developed paranoid delusions after an increase in his venlafaxine dosage to 150 mg per day. The patient, who was in hospice care for end-stage renal failure and other health issues, exhibited paranoia within 72 hours of the dosage increase, believing he was being abused and poisoned. Despite reducing the venlafaxine dose, the paranoia persisted until the medication was discontinued, after which the symptoms resolved completely within 48 hours. When venlafaxine was restarted, the paranoia returned, confirming the association. Switching to sertraline resolved the paranoia and improved his anxiety and depression, with no further episodes during the last 5 weeks of his life. This case highlighted a potential link between venlafaxine use and the development of paranoid symptoms.