(2006) and Teunisse and Olde Rikkert (2012) has shown that MH are more common than previously assumed, with prevalence rates of 3.6% among groups of patients referred for audiometric testing. The most relevant etiological factors for MH, as reported in the literature, are brain injuries, epilepsy, psychiatric disorder, and intoxication/pharmacology ( Berrios, 1990 Keshavan et al., 1992 Evers and Ellger, 2004 Cope and Baguley, 2009). When there are associated pathological abnormalities, they are named symptomatic MH ( Coebergh et al., 2009). When they occur without the presence of any associated pathological abnormalities-with the exception of hearing impairment (hypoacusis)-they are called idiopathic MH. We therefore endeavored to identify which treatments have been tried under which circumstances, and what their effect has been upon the MH. Furthermore, case reports tend to over represent positive responses, as negative responses to specific medication are rarely published. The principle reason for this would seem to be that published case series are relatively small, and that the mechanisms responsible for the mediation of MH are probably diverse. The scientific interest in these phenomena has increased significantly over the past 25 years, but so far no evidence-based treatments have been established. Musical hallucinations (MH) are auditory hallucinations characterized by songs, tunes, melodies, harmonics, rhythms, and/or timbres ( Coebergh et al., 2009). There is also a need to standardize the assessment of treatment responses, and document long-term follow up. There is a need to establish the natural course of musical hallucinations, their response to non-pharmacological treatments, and their effects on the patient's quality of life. When intoxication/pharmacology is the main etiological factor, it is important to stop or switch the causative substance or medication.Ĭonclusion: Treatments for musical hallucinations tend to yield favorable results when they target the main etiological factor of these phenomena. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. The limited use of acetylcholinesterase inhibitors has looked promising. Pharmacological treatment methods can also be successful, with antidepressants being possibly more helpful than antiepileptics (which are still better than antipsychotics). In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g., more acoustic stimulation) are frequently helpful. Distinct etiological groups appear to respond differently to treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. When hallucinations are bearable, patients can be reassured without any other treatment. Results: Musical hallucinations can disappear without intervention. We analyzed the treatment results in relation to the etiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion, and other pathology, epilepsy or intoxication/pharmacology. Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. Objective: To review the effects of published treatment methods for musical hallucinations. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. 8Department of Psychiatry, University of Groningen, Groningen, Netherlandsīackground: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking.7Brain Centre Rudolf Magnus, Utrecht, Netherlands.6Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands.4Parnassia Psychiatric Institute, The Hague, Netherlands.1Department of Neurology, Haga Hospital, The Hague, Netherlands.
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