Transient Musical Hallucinations in a Young Adult Male Associated with Alcohol Withdrawal

Abstract

We present the case of a 25-year-old male who presented to A&E with isolated musical hallucinations, in the absence of audiological or neurological disease. The patient had a history of recreational drug use and a family history of psychosis. Hallucinations, which were preceded by discontinuation of alcohol and reinitiation of citalopram for depression, resolved spontaneously after three days. Aetiological factors are discussed alongside the existing literature. Whilst the underlying mechanisms underpinning musical hallucinations remain elusive, the case illustrates the potential role of alcohol withdrawal, serotonin toxicity, recreational drug use, and genetic vulnerability.

Drug-induced musical hallucination

“…Twenty-four articles met our inclusion criteria ( Vallada and Gentil, 1991 ; Terao, 1995 ; Kumagai et al, 2003 ; Padala et al, 2010 ; Muraosa et al, 2020 ; Kobayashi et al, 2004 ; Gondim Fde et al, 2010 ; Kataoka and Ueno, 2014 ; Keeley et al, 2000 ; Moore, 2003 ; Davies and Quinn, 2005 ; Powers et al, 2015 ; Agrawal and Sherman, 2004 ; Zonios et al, 2008 ; Fisman, 1991 ; Curtin and Redmund, 2002 ; al-Zahawi et al, 1988 ; Song and Jung, 2019 ; Gilbert, 1993 ; Tomar and Cheung, 2007 ; Blackman et al, 2019 ; Elikowski et al, 2021 ; Kanemura et al, 2010 ; Allen, 2008 ). The flow of the literature search is illustrated in Figure 1 .…”

The phenomenon of musical hallucinations: An updated review

“…Drug and substance toxicities can produce MHs. Drugs associated with the development of MHs in the case reports reviewed in our paper include amiodarone, paroxetine, cefrazidime, mirtazapine, pramipexole, steroids, and amantadine; MHs were also associated with alcohol withdrawal [18,20,22,23,27,42,57,59]. Other drugs associated with MHs include stimulants, opiates, benzodiazepine, lisinopril, ramelteon, carbidopa/levodopa, and clarithromycin [70].…”