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Cyclobenzaprine (Flexeril; Merck & Co Inc, West Point Pa) is indicated and used in most patients for the treatment of muscle spasm associated with acute painful musculoskeletal conditions. Anticholinergic adverse effects are commonly seen in patients taking cyclobenzaprine; however, insomnia, hallucinations, and excitement have been reported and are common manifestations of drug toxicity.^1-2 Elderly patients may be more susceptible to adverse drug events and toxic effects when taking recommended doses of medications as a result of several pathophysiological changes that occur with aging.³ We describe a case of hallucinations occurring in an elderly woman who had been prescribed a commonly recommended dose of cyclobenzaprine.

Report of a Case

A 76-year-old woman was admitted to the acute-care medicine service on April 25, 1999, with acute mental status changes manifesting as hallucinations, sleeplessness, restlessness, and decreased appetite. The patient was known to have a long-standing history of severe rheumatoid arthritis, hypertension, coronary artery disease, and chronic . . . [Full Text of this Article]

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