Drug-induced musical hallucination

Area of Science:

• Neurology
• Pharmacology
• Psychiatry

Background:

• Musical hallucination is a rare perceptual disturbance involving auditory experiences of music without external stimuli.
• This phenomenon can be associated with various medical conditions and is sometimes triggered by specific medications, with unknown underlying mechanisms.

Purpose of the Study:

• To explore drug-induced musical hallucination by reviewing existing literature.
• To investigate the pathophysiology and potential treatment strategies for drug-induced musical hallucinations.

Main Methods:

• A comprehensive literature search was conducted across PubMed, WorldCat, Google Scholar, and DOAJ up to January 2024.
• Keywords used were "drugs induced musical hallucination" and "drugs" combined with "musical hallucination," yielding 24 articles and 27 cases.

Main Results:

• The study analyzed 27 cases, with an average patient age of 58.3 years (67.9% female), often presenting with hearing impairments, psychiatric disorders, cancers, or neurodegenerative conditions.
• Commonly implicated drugs included antidepressants, opioids, anti-Parkinson drugs, ketamine, and voriconazole. Symptom onset varied from 75 minutes to 240 days.
• Treatment involved drug cessation, dosage adjustment, or switching medications, leading to complete resolution in 88.9% of patients.

Conclusions:

• Drug-induced musical hallucination may result from altered neurotransmitter/receptor balance.
• Interactions between trigger drugs and pre-existing conditions likely play a role in the pathophysiology.
• Effective management often involves modifying the causative medication, with a high rate of symptom resolution.