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Background
Auditory hallucinations are common in schizophrenic patients whereas a few case reports have described antidepressant-induced auditory hallucinations. 1 2 To the best of our knowledge, this is the first report of trazodone-induced auditory hallucinations.
Case presentation
In February 2006, an 18-year-old female patient was referred to the psychiatric outpatient department of our university hospital. She had been bullied at elementary school and junior high school, suffering from a chronic anxiety state and insomnia since then. She also suffered from nasal and paranasal papilloma to which several surgical operations were performed at the department of otolaryngology and she had lumbago which was treated at the department of orthopaedic surgery of our university. Her elder brother died in an accident (drowning in a pond) when he was 4 years old and her younger brother suffered from school phobia and had received psychiatric treatment. Her parents divorced when she was at junior high school.
The patient suffered from a depressive state consisting of depressed mood, guilty ideation, suicidal thoughts, insomnia, anxiety and general fatigue. She scored 19 points on the Hamilton Depression Rating Scale (HAM-D). According to the Diagnostic and Statistical Manual-IV (DSM-IV-TR), she met the criteria for major depressive disorder. Milnacipran (50 mg/day), mianserin (20 mg/day) and flunitrazepam (2 mg/day) were started, but she could not tolerate both milnacipran and mianserin due to nausea and so on. Thereafter, paroxetine and subsequently fluvoxamine were tried in small doses but she did not comply regularly and she eventually discontinued this treatment. She continued to take flunitrazepam, brotizolam and levomepramazine for several years. Several attempts were made to start antidepressants for her depression, but she was very sensitive to them and quit them as...