According to a study published in the International Journal of Clinical and Health Psychology, a repetitive transcranial magnetic stimulation (rTMS) protocol significantly reduces auditory hallucinations, including in patients taking clozapine. A work reported by the CH Le Vinatier, who contributes to it.
Repetitive transcranial magnetic stimulation (rTMS) is a technique that uses a coil to send magnetic pulses into the brain. She has recently emerged as a therapeutic option for patients with treatment-resistant verbal auditory hallucinations, that is, voices that cannot be stopped by commonly used medications. However, we do not yet distinguish the best settings of stimulation for these patients, in particular for those resistant even to drugs of last resort such as clozapine.
The PSYR2 study
In Lyon, researchers from PSYR2 (Psychiatric pathologies, from resistance to response) conducted a study to see if the stimulation parameters they had used with success in patients with major depression may also help patients with auditory hallucinations. They included 14 participants, including 9 receiving clozapine, who received 30 sessions of rTMS at 1 Hz over a period of 3 weeks. Stimulations were applied to a specific region of the brain known to be involved in hallucinations: the left temporoparietal junction.
Results and conclusion of the study
The results showed that following the rTMS, the participants showed a significant reduction their auditory hallucinations, including in patients on clozapine. Finally, the researchers conclude that low-frequency rTMS (30 sessions over 3 weeks) is a promising approach to reduce treatment-resistant verbal auditory hallucinations. However, they also point out that these results must be confirmed by larger, controlled studies before they can be used in clinical routine.
• Twice daily low frequency rTMS for treatment-resistant auditory hallucinations, J. Brunelin, F. Galvao, M. Mondino. Int J Clin Health Psycho, 2023 Jan-Apr;23(1):100344. voir pubmed
