Rapid Improvement of Auditory Verbal Hallucinations in Schizophrenia After Add-On Treatment With Transcranial Direct-Current Stimulation

Abstract

Treatment of nonresponsive auditory hallucinations in schizophrenia have been reported to improve with transcranial direct-current stimulation. This case description illustrates the use of add-on transcranial direct-current stimulation for rapid amelioration of auditory hallucinations in schizophrenia during the acute phase. Because transcranial direct-current stimulation is safe, largely well tolerated, and relatively inexpensive, this add-on treatment option is worth exploring through further rigorous studies.

Transcranial Direct Current Stimulation for Refractory Auditory Hallucinations in Schizophrenia

“…The treatment gains were apparent by the end of the 5-day tDCS course and were maintained for 3 months. 35 Patients in the case reports 18,31,[33][34][35] showed substantial response to tDCS, whereas those in the RCT 36 showed attenuation of hallucination ratings by only about a third. There are 2 likely explanations for the modest improvement recorded in the RCT.…”

“…In all case reports 18,[31][32][33]35 bar 1 34 and in the RCT 36 as well, ongoing treatment with antipsychotic and other medications continued unchanged during the tDCS trial. It therefore appears that tDCS can be safely and effectively combined with antipsychotic medication.…”

“…No adverse effects were associated with tDCS, nor were cognitive impairments evident on neuropsychological testing. Shivakumar et al 33 described a 28-year-old woman with continuous, derogatory auditory hallucinations occurring during a relapse of schizophrenic illness. After 8 days of antipsychotic and benzodiazepine treatment, she was started on tDCS.…”

“…36 At least 1 report, each, has described tDCS in combination with clonazepam 33 and clozapine. 18 However, given that tDCS influences cortical excitability, more information is necessary on how drugs that influence cortical excitability (benzodiazepines and other anticonvulsants; clozapine and other proconvulsants) modulate the efficacy of tDCS.…”

Transcranial direct current stimulation als behandeling voor auditieve hallucinaties

“…De linker-DLPFC is veel gebruikt in studies naar de effecten van tDCS op cognitief functioneren [8]. Deze twee specifieke locaties zijn nog in enkele andere casusbeschrijvingen gebruikt, waarbij de behandeling een positief effect liet zien op de ernst van AH na meerdere sessies tDCS-stimulatie van 20 minuten op een wat hogere intensiteit, namelijk een sterkte van 2 mA [9][10][11][12]. Echter, in al deze gevallen ging het om open-labelbehandeling zonder controleconditie, waarbij aspecifieke effecten (i.e.…”