Q:  Auditory Hallucinations - How Does the Medication Work in the Brain?

My Mother has a diagnosis of bi polar with delusions.  

One of the main components of her latest relapse was hearing a voice in her head. The voice is a person and the voice was very loud and telling her what to do. She has been prescribed 75mg of Seroquel at bedtime.  

Could you tell me how the medication actually works on the brain to quiet the voice in my Mothers head? 

Thank you     
    

Dear Mr. B' --

The long answer is very long, and even the short answer which I will attempt here is going to tend toward getting too long as well!   Psychiatry does not enjoy a great reputation amongst the general public, in part because we oftentimes don't really have a good answer to a question like the one you ask here.  So when we actually do have a good answer, it's tempting to really go on about it. Anyway, here goes -- 

Auditory hallucinations appear to be the mistaking of one's own thoughts for a "voice". At least that is the working theory about where they come from.  The region of the brain which produces auditory hallucinations is very close to the region of the brain where our thoughts are converted into words (“Broca’s area” ).^Strik 

In these and other related regions of the brain, when people are having auditory hallucinations, it appears that a neurotransmitter called dopamine reaches levels of activity that are abnormally high. This problem is treated with antipsychotic medications (psychosis means loss of contact with reality, one form of which is auditory hallucinations). Seroquel is one of those. Most of the antipsychotic medications act by lowering levels of dopamine activity.  

If you want to dig deeper, try searching for more general information about psychosis and dopamine.  The Wikipedia section on the basis of psychosis is rather detailed but might be a reasonable starting place.  Good luck with your learning --
 

Dr. Phelps




Published July, 2008