Seeing things that are not really there? One of your medications may be the culprit.

Could a prescribed medication be a factor?

It is known that moderate to significant vision loss can be a notable risk factor for a person developing unusual visual experiences. Indeed, the vast majority of people living with Charles Bonnet syndrome will have some form of vision impairment. This often is due to eye injury or disease.

What is not so well known is that sometimes the cause of the visions can lie with the person's own prescribed medications. We are all aware that prescribed medication can sometimes come with unforeseen side effects. This can extend to seeing things that are not really there. One particular drug introduced or the interaction effects of multiple medications can occasionally set off Bonnet-like visions, especially in the elderly. In such cases, if the offending medication can be identified and switched (or discontinued) then the symptoms could be reversible.

This medication effect can also occur with a person who is already living with CBS. Suddenly, the person may experience a change in the actual content or frequency of their visions and find them unsettling in a way that they never had before. This situation can sometimes be a clue that another factor (eg. medication) may be at play.

The Foundation has previously commented on studies suggesting that people living with the wet form of macular degeneration are twice as likely to experience CBS if they are taking a proton pump inhibitor (a commonly prescribed medicine for reducing stomach acid/heartburn). Many drugs used to treat high blood pressure or various heart ailments (ie. beta blockers) have also been known to trigger visions of things that are not really there (Doane et al, 2013).

A 2015 study undertaken in France looking back over the past 30 years found an association between prescribed medications and hallucinations. This covered a wide range of drugs including not just the above medications but also antidepressants, sedatives and pain management drugs. 

The point of drawing attention to this association is not to generate undue alarm but rather to be mindful that on rare occasions, the CBS-like experience may accidentally lie at the hands of a prescribed medication and to explore that possibility with your treating doctor. 

 

Summary

• For those of advanced years, who may be on several medications, potential drug interactions may in some instances set off symptoms similar to Charles Bonnet syndrome. 

 

• If you (or someone you love) suddenly begins experiencing unusual phantom images, consider whether a new medication has recently been introduced or the dosage of a usual medicine has been increased. It may be that by (a) adjusting the dosage, (b) switching to an alternate drug option or (c) even eliminating the suspected culprit could see the phantom images resolve. Naturally, these options are to be only undertaken with the guidance of a medical professional. 

 

REFERENCES

Doane, J. et al (2013). Visual hallucinations Related to Angiotensin-Converting Enzyme Inhibitor Use: Case Reports and Review. The Journal of Clinical Hypertension, 15(4): 230-233

Leandro, JE. et al (2017). The Charles Bonnet Syndrome in Patients with Neovascular Age-Related Macular Degeneration: Association with Proton Pump Inhibitors. Investigative Ophthalmology and Visual Science, 58(10): 4138-4142.