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Resolution of hyperacusis associated with depression, following lithium administration and directive counselling

  • D Attri (a1) and A N Nagarkar (a1)
Abstract
Introduction:

Hyperacusis may be described as a decreased threshold for discomfort from sound. It may have a serious impact on an individual's lifestyle, as a result of decreased sociability and inability to spend time with family and friends due to intolerance of sound.

Subject:

We present a case of hyperacusis associated with depression, with no other audiological abnormality. The patient reported greater difficulty during the depressive episode.

Method:

Audiological investigation was undertaken, followed by counselling and medication for depression.

Results and conclusion:

The pathophysiological mechanism of hyperacusis in depression is discussed. Outcomes following treatment with directive counselling and lithium (an antidepressant) are described. Research indicates that both hyperacusis and depression can be caused by hypoactivity of 5-hydroxytryptamine (also known as serotonin) in the brain. The patient reported improvement which cannot be explained solely on the basis of counselling. Enhancement of serotonin activity due to lithium, prescribed for depression, may also play a role in alleviation of hyperacusis.

Copyright
Corresponding author
Address for correspondence: Dr Anu N Nagarkar, Speech and Hearing Unit, Department of Otolaryngology-Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. E-mail: nitinanurishabh@yahoo.com
References
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1 Baguley, DM. Hyperacusis. J R Soc Med 2003;96:582–5
2 Carmen, JS. Imipramine in hyperacusic depression. Am J Psychiatry 1973;130:937
3 Marriage, J, Barnes, NM. Is central hyperacusis a symptom of 5-hydroxytryptamine (5-HT) dysfunction? J Laryngol Otol 1995;109:915–21
4 Jasterboff, PJ, Jasterboff, MM. Tinnitus retraining therapy for patients with tinnitus and decreased sound tolerance. Otolaryngol Clin North Am 2003;36:321–36
5 Hyperacusis test. In: http://www.hyperacusis-info.org [6 December 2009]
6 Owens, MJ, Nemeroff, CD. Role of serotonin in the pathophysiology of depression – focus on the serotonin transporter. Clin Chem 1994;40:288–95
7 Thompson, GC, Thompson, AM, Garrett, KM, Britton, BH. Serotonin and serotonin receptors in the central auditory system. Otolaryngol Head Neck Surg 1994;110:93102
8 Prince, LH, Charney, DS, Delgado, PL, Heninger, GR. Lithium treatment and serotoninergic function. Arch Gen Psychiatry 1989;46:1320
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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