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Irish Journal of Medical Science (1971 -)

09-05-2024 | Antidepressant Drugs | Case based reviews

A case series of musical hallucinations in psychiatry of old age—in search of the sound of silence

Authors: Ralph Twomey, Anna Young, Caoimhe Clarke

Published in: Irish Journal of Medical Science (1971 -)

Abstract

Musical hallucinations (MH) are the subjective experience of hearing music when none is played. They are a rare, understudied area of psychiatry. MH are more common in women and older age and have several underlying aetiologies and predisposing factors such as hearing impairment, mental illness and certain medications. There are no consensus guidelines on treatment; thus, current treatment has two broad approaches: (1) the removal of potential inciting factors (e.g. optimising hearing aids, medications) or (2) pharmacotherapy (antipsychotics, antidepressants, mood stabilisers and cognitive enhancers). This paper presents a case series of patients presenting with MH to a psychiatry of old age service in Dublin City and reviews the current literature of MH. Older age, female gender and hearing impairment are known risk factors for MH. Our findings concurred with the literature—two of three patients were female, and two of three patients suffered from hearing impairment. As this was a psychiatry of old age service, all patients were elderly. One case had a swift resolution of symptoms with a combination of an antipsychotic and antidepressant. The other two cases had limited responses to treatment despite optimising their hearing aids and trials of a number of medications at therapeutic levels. Further research into MH is needed to establish a treatment that is evidence based and symptom focused.

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Title: A case series of musical hallucinations in psychiatry of old age—in search of the sound of silence
Authors: Ralph Twomey
Anna Young
Caoimhe Clarke
Publication date: 09-05-2024
Publisher: Springer International Publishing
Keywords: Antidepressant Drugs
Antidepressant Drugs
Antipsychotics
Antipsychotics
Carbamazepine
Published in: Irish Journal of Medical Science (1971 -)
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-024-03693-7

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