The patient is a 70-year-old man who developed depression symptoms, such as depressed mood, lack of interest, lack of energy, anhedonia, insomnia, and weight loss, within the previous month (Hamilton Rating Scale for Depression [Ham-D] score: 26). No concurrent severe medical illness (including Parkinson’s disease or head injury) was noted, except hypertension. Under the impression of nonpsychotic depression, he started to receive escitalopram 5 mg/day for the first 2 weeks, and then the dose of escitalopram was titrated to 10 mg/day, given no intolerable side effects and persisting significant depression at 5 mg/day treatment. The depression symptoms improved under escitalopram therapy for 1 month (Ham-D score: 10). However, he began to see nonexistent strangers talking to him after using escitalopram for 3 days. The commands and comments were loud and clearly heard. No significant findings were found in the magnetic resonance imaging of brain. The VH is significant after using escitalopram 10 mg/day for 1 month. His Clinical Dementia Rating (CDR) score was 0.5 and Mini-Mental State Exam (MMSE) score was 23, which showed no significant evidence of senile dementia or delirium. However, he still had significant VH and AH during the escitalopram treatment. Under the impression of possible SSRI-related VH and AH, we began to taper the dose of escitalopram to 5 mg/day within 1 week and then completed withdrawal from escitalopram within 2 weeks. The VH and AH almost disappeared after withdrawal from escitalopram for 1 month. There was no relapse of depression in this case after quitting escitalopram treatment.