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Tijdschrift voor Psychiatrie 56 (2014) 4, 247 - 256

Review article

Treatment strategies for auditory verbal hallucinations

C.W. Slotema, J.D. Blom, I.E.C. Sommer

Background  Auditory verbal hallucinations (avh) are experienced not only by patients diagnosed with schizophrenia, but also by patients with other disorders (some of which may be psychiatric) and in the general population. The ensuing affliction may be severe and can sometimes result in dangerous behaviour. Although various treatment options are available for avh, only a few have been investigated in randomised placebo-controlled trials.
aim To provide an overview of the literature relating to the effectiveness of antipsychotics, cognitive-behavioural therapy (cbt), electroconvulsive therapy (ect), and transcranial magnetic stimulation (tms) in the treatment of avh.
method This review paper is based on the Ph.D. study of the first author; in addition, a literature search was carried out using PubMed.
results Antipsychotics have never been studied specifically with regard to their effect on avh, but they are known to lead to a significant decrease in the severity and frequency of hallucinations in general. cbt can reduce the torment caused by avh, but not the severity or frequency. ect can be helpful in the treatment of drug-resistant psychosis, but it has never been studied specifically with regard to its effect on avh or on other types of hallucinations. tms is effective for the treatment of drug-resistant avh, but in the cases where it has been used so far, the beneficial effects seem to have been of limited duration.
conclusion Very few of the available treatment strategies have been used specifically to relieve the distress caused by avh. tms and cbt have proved reasonably effective, but there is a need for further research into additional treatment strategies, particularly into those involving tms.

keywords antipsychotics, auditory hallucinations, clozapine, cognitive-behavioural therapy, electroconvulsive therapy, transcranial magnetic stimulation