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A 55-year-old man experienced visual hallucinations following treatment with duloxetine for major depressive disorder and chronic pain. The man, who was receiving quetiapine, started receiving duloxetine 20mg for refractory major depressive disorder and chronic pain; he developed visual hallucinations following dose elevation to 40 mg/day [duration of treatment to reaction onset and route not stated]. The hallucinations were described as a stranger, a floating quilt, and smoke. His duloxetine dose was reduced prior to discontinuation; the visual hallucinations resolved following quetiapine dose elevation. Tests revealed a thyroid-stimulating hormone value of 7.01 µIU/mL.