Tiapride for the Treatment of Auditory Hallucinations in Schizophrenia
A 32-year-old married 10th standard educated female was brought to the out-patient department by her sister with complaints of suspiciousness toward the neighbors that they are talking about her and that they would kill her and her family members since the past 6 months. She would feel that they are keeping a watch on her by cameras fitted in her house by them. She would also hear voices inaudible to others commenting on her actions and sometimes giving running commentary also. She also had decreased sleep and decreased working ability. She was diagnosed as having Paranoid Schizophrenia as per DSM-IV TR criteria and was started on risperidone 4 mg/day and trihexyphenidyl 4 mg/day. Gradually risperidone was increased to 8 mg/day in weekly increments and trihexyphenidyl to 6 mg/day. Her symptoms showed no improvements after 1 month and olanzapine 10 mg/day was added, which was increased gradually to 20 mg/day. Her suspiciousness reduced and her sleep improved. She started doing routine and household activities. However, her complains of auditory hallucinations were persistent even 6 months of treatment. She and her family members were not consenting for ECT and tiapride 50 mg/day in divided doses was added to her medication. She started feeling better, her voices began to reduce and the intensity and frequency of hallucinations decreased. Tiapride was gradually raised to 150 mg/day in divided doses. The patient claimed 80% improvement in auditory hallucinations after 2 months of addition of tiapride to her medication. Her total score on the PSYRATS-hallucination subscale improved from 41 to 25 after addition of tiapride.