Successful risperidone therapy for a first episode of musical auditory hallucinations in elderly patients

Although musical auditory hallucinations (MH) occur mostly in women with a history of hearing disorders, brain tumors or epilepsy, there has been insufficient symptomatological discussion to date. We present two cases in which MH occurring in old age were successfully treated with risperidone (RIS). Case 1 involved a 74‐year‐old woman who complained chiefly of insomnia and abrupt onset of MH without any other symptoms. Case 2 involved an 85‐year‐old woman with a 10‐year history of symptomatic hearing loss who had abrupt onset of MH accompanied by tinnitus. Neither patient had a history of mental illness before their initial examination and they were both treated with RIS in the outpatient clinic. The dose range of 0.2–0.5 mg daily seemed effective, with a therapeutic response appearing in 2–4 weeks. Low‐dose RIS therapy may therefore be effective pharmacotherapy for MH.