Describe the possibility that medications without anticipated anticholinergic effects can have that type of side effect.

We would like to present a 57-year-old patient, admitted to hospital because symptoms of major depressive episode with psychotic features. The main symptoms were auditory delusions with imperative character, base diminished mood and unregulated restless sleep. Psychological testing is obtained and showed the difficulty in sustaining attention, confused thinking, a strong depressive shift, a drop of vital energy, hypersensitivity, which turned into projections.

At the beginning of hospitalization were corrected prescribed drugs before admission and transferred to fluvoxamine and at sixth day of hospitalization, quetiapine was added, with a gradual reduction until the termination of risperidon and promasinum. Within a week after taking fluvoxamine in dose of 200 mg per day patient allege the occurrence of dry mouth.

Regard that the quetiapine and fluvoxamine usually have tha side effect of dry mouth, We have decided to reduce the dose of fluvoxamine on the usual daily-defined dose of 100 mg and the dose of quetiapine keep the same, because at lower doses at patient were still present auditory hallucinations.

Regard that the reduction of dose of fluvoxamine showed also reduction of side effect, we believe that in the presented case fluvoxamine was drug responsible for the appearance of aforementioned side effect, although we do not exclude a synergistic effect.