SOURCE: Psychiatry and Clinical Psychopharmacology. Conference: 9th International
Congress on Psychopharmacology and 5th International Symposium on Child
and Adolescent Psychopharmacology. Antalya Turkey. 27 (Supplement 1) (pp
158-159), 2017.

DATE OF PUBLICATION: May 2017.

AUTHORS: Sari D.; Ispir M.; Algul A.; Ebrinc S.

ABSTRACT: Auditory hallucinations are described as auditory experiences without the presence of out stimuli. They are most strongly linked to schizophrenia but are also characterized in patients with Alzheimer disease and patients with epilepsy. Persistent auditory hallucinations (AHs) are a general problem in patients with schizophrenia and contribute to going on disability and morbidity. Repetitive transcranial magnetic stimulation (rTMS) has recently been developed and trialed as a possible, novel treatment for patients with treatment resistant AHs. rTMS has been subjected to a few small randomized controlled trials. On the other hand, little is known about the long-term impact of rTMS on the clinical outcome of patients with persistent auditory hallucinations. We used PSYRATS scale and Positive and Negative Syndrome Scale (PANSS) for auditory hallucinations. PSYRATS scale provides an assessment of 11 dimensions of hallucination severity and character and has established validity and reliability. The PANSS was also used to measure general psychotic symptoms and psychopathology. A 35-year-old right handed man, suffering from auditory hallucinations presented to the psychiatry clinic. He had been treated over this time with multiple typical and atypical antipsychotic medications at full therapeutic doses. These had resulted in a recovery in his general clinical state but had little impact on the existence or severity of his hallucinations. At the time of first rTMS he had been admission treatment with a combination of quetiapine (400 mg/day) and aripiprazole (20 mg/day) for over 12 months. He was enrolled of treatment and received 10 days of rTMS. This was provided for 15 minutes per day, at 1 Hz, left temporoparietal cortex at 90% of the resting motor threshold. This resulted in a dramatic reduction of his auditory hallucinations from PPSRS and from PANSS AH item. His total PANSS score decreased from 67 at baseline to 42 at study end.