Jack Golder, Julia Isom
Background: Lisinopril is generally well tolerated, but rare neuropsychiatric adverse effects have been reported. Case: We describe an 89-year-old woman who developed vivid nocturnal auditory and visual hallucinations approximately 3 months after starting lisinopril for hypertension. Neurologic examination, imaging, and laboratory evaluation were unremarkable. Hallucinations resolved completely within 2 weeks of drug discontinuation, with no recurrence on follow-up. Conclusion: Older adults may be particularly susceptible to medication-induced neuropsychiatric effects. Recognition of lisinopril as a reversible cause of hallucinations is essential to avoid misdiagnosis and unnecessary treatment.