Pharmacological and Non-Pharmacological Interventions for Persistent Auditory Hallucinations in Schizophrenia

摘要

Refractory auditory hallucinations warrant evidence-based pharmacological and non-pharmacological treatment strategies. The current psychotropic medications have only modest anti-hallucinatory effect and the efficacy of non-pharmacological therapies is not well established. While clozapine seems to have the maximum anti-hallucinatory effect, some patients remain super-refractory even to clozapine treatment. Thus, going forward research should focus on the discovery of a derivative of clozapine that is free from the haematological side-effects, as this could lead to remarkable advancements in the treatment of schizophrenia. Recent years have witnessed an interest in the development of various forms of non-pharmacological approaches to addressing this problem alongside pharmacotherapy. Pharmacotherapy alone may not be the answer to refractory auditory hallucinations and a greater spectrum of non-pharmacological therapies is clearly needed. In this work, different forms of non-pharmacological therapies are reviewed, including CBT, which has gained popularity as a psychological intervention and an efficacious form of voice therapy. Antipsychotics are also reviewed, revealing that, despite having only modest anti-hallucinatory properties, they are essential for reducing the psychic pain and correcting the underlying psychotic process.