Schizophrenia is a really challenging illness. There's been a lot of progress made recently, I will note. I've already written about novel treatments like Cobenfy, and using accelerated transcranial magnetic stimulation for negative symptoms and positive symptoms in schizophrenia. One of the most bothersome of those “positive symptoms”—things that shouldn't be there, in someone's mind, but are—are auditory hallucinations. If you imagine having invisible AirPods that are playing a terrible podcast that you'd rather not be listening to, and that everyone else can't hear, you get a sense of how distracting it might be to have auditory hallucinations.
In my previous article about the treatment of auditory hallucinations with transcranial magnetic stimulation (TMS), one of my favorite forms of brain stimulation, I highlighted promising results from early studies. Now we have a much larger Study, phase 3 trial, conducted over many years in Germany. We are even at the level of meta-analysis at this point!
It’s a considerable study:
138 adults with treatment-persistent auditory verbal hallucinations and schizophrenia spectrum disorder were randomly assigned (1:1) to receive 15 sessions of active (n=70) or sham cTBS (n=68) administered sequentially as 600 pulses to the left and 600 pulses to the right temporo-parietal cortex over a 3-week period.
I called friends of the podcast—Dr. David Garrison, Dr. Will Sauve, and my mom, Vita Muir, to talk through this paper together, and what it might mean for individuals suffering from psychotic disorders. In the meantime, the team at Radial, where we provide such treatment, does some funny, tough-guy faces with our Ampa One system:
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