Second trial of repeated transcranial magnetic stimulation in a schizophrenic patient with persistent auditory hallucinations

We report the case of a 30-year-old male schizophrenia patient with persistent auditory hallucinations (AHs) who had received 1 Hz repeated transcranial magnetic stimulation (rTMS) to the left temporoparietal cortex in 2 separate trials. He had suffered from severe persistent AHs for more than 5 years. Four different combinations of two antipsychotics were tried at high doses, without any observable beneficial effects. He was admitted for the administration of rTMS. At the start of the 2^nd week of the 1 ^st rTMS trial, he reported a substantial improvement of AHs with a further reduction to 30% of baseline severity at the end of the 3rd week. However, AHs were returned to baseline levels at about 2 months after discharge. The 2^nd rTMS trial produced no therapeutic benefit. The length of beneficial effects of the 1^st rTMS trial as well as possible effects of the 2^nd rTMS trial on the returned AHs needs to be established with a large sample size.