Charles Bonnet Syndrome: Complete Remission of Visual Hallucinations with Trazodone

Abstract

Charles Bonnet syndrome (CBS) is a neuro-ophthalmic condition that affects elderly people with visual impairment related to ophthalmological pathologies. It is characterized by complex visual hallucinations with insight into the unreality of the perceptions and preserved cognitive status. Its mechanism involves spontaneous neuronal discharges of the visual cortex secondary to deafferentation of visual input. Treatment should address to its ophthalmologic etiology but pharmacological management of visual hallucinations may be done as well. We report a case of an 86-year-old woman with a characteristic clinical picture of CBS that had complete remission of her visual hallucinations with trazodone treatment. Perhaps trazodone effect on blocking neuronal plasticity through its action at 5-HT2C receptors may control visual hallucinations. Its prescription should be considered as one of the first steps in the management of Charles Bonnet syndrome.