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2015 ; 6
(ä): 814
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Musical hallucinations: review of treatment effects
#MMPMID26136708
Coebergh JA
; Lauw RF
; Bots R
; Sommer IE
; Blom JD
Front Psychol
2015[]; 6
(ä): 814
PMID26136708
show ga
BACKGROUND: Despite an increased scientific interest in musical hallucinations
over the past 25 years, treatment protocols are still lacking. This may well be
due to the fact that musical hallucinations have multiple causes, and that
published cases are relatively rare. OBJECTIVE: To review the effects of
published treatment methods for musical hallucinations. METHODS: A literature
search yielded 175 articles discussing a total number of 516 cases, of which 147
articles discussed treatment in 276 individuals. 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. RESULTS: Musical hallucinations can disappear without
intervention. When hallucinations are bearable, patients can be reassured without
any other treatment. However, in other patients musical hallucinations are so
disturbing that treatment is indicated. Distinct etiological groups appear to
respond differently to treatment. In the hypoacusis group, treating the hearing
impairment can yield significant improvement and coping strategies (e.g., more
acoustic stimulation) are frequently helpful. Pharmacological treatment methods
can also be successful, with antidepressants being possibly more helpful than
antiepileptics (which are still better than antipsychotics). The limited use of
acetylcholinesterase inhibitors has looked promising. Musical hallucinations
occurring as part of a psychiatric disorder tend to respond well to
psychopharmacological treatments targeting the underlying disorder. 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. When intoxication/pharmacology is
the main etiological factor, it is important to stop or switch the causative
substance or medication. CONCLUSION: Treatments for musical hallucinations tend
to yield favorable results when they target the main etiological factor of these
phenomena. 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. There is also a need to standardize the
assessment of treatment responses, and document long-term follow up.
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