Treatment Options, One Person’s Perspective

This was posted on a misophonia group by the father of person with misophonia.  I think it is a fairly reasonable overview.

It is posted here with his permission, unedited except for removing his name.

Re: help for my 12 year old

Fri Jan 17, 2014 10:59 am (PST) . Posted by: xxxxx

Unfortunately, I don’t think there is anything out there with a demonstrated high probability of efficacy. There are several reports people trying neurofeedback (NFB). The results have ranged from no impact to virtually 100% elimination of symptoms. NFB is tough to evaluate because it is not a particularly mature technique and the results you get probably depend a lot on the practitioner. Also, those who have reported success have done a lot of sessions (>80) while a typical NFB treatment regime for other ailments might only be 20-40. If they are being administered by a professional each time it gets very expensive. Some practitioners support home treatment which can make things much more economical. At least one person has reported benefit of using Zengar Neuroptimal, which is a type of neurofeedback that doesn’t care what pathology is being addressed. It claims to generally improve brain performance. It is not obvious at all how this is supposed to work, and there is very little data backing its efficacy. However, there are a lot of “trainers”; offering it and presumably people find it useful (at least in certain domains). I don’t find that a particularly compelling argument as there are lots of people that believe in homeopathy and numerology too (which I obviously consider to be nonsense). I haven’t completely dismissed the possibility that the Zengar brain training can help, but I’ve chosen to go the classical NFB route with my daughter.CBT and similar therapies have been reported by many people to be helpful. They don’t eliminate misophonia but can make it much easier to deal with.

I think several people have found that getting good at muscle relaxation helps a lot. At least one guy feels like it has effectively made his misophonia a non-issue for him. I want to get my daughter to try this.

Tom Dozier has been trying out a counter-conditioning treatment and reported some (but not universal) success. He can work with people remotely. He has also worked with a chiropractor who has developed some sort of treatment (I don’t think it is a classical chiropractic approach, but some other modality based on “meridians" which I think is an Eastern Medicine concept). With a very small sample set they have reported dramatic improvement/elimination of symptoms in subjects with moderate misophonia, and lack of response in someone with severe misophonia. They are looking for more people to try this out on and even with air fare to Utah would probably be cheaper than NFB. However, the whole concept of “meridians" sounds hokey to me so I’m very skeptical.

Some people have reported benefits from various medications (anti-depressants, drugs for OCD, etc.) while others haven’t been helped. I think that since misophonia is worse or harder to deal with when stressed that these probably help by stabilizing the mental environment but are not likely to be addressing the misophonia directly. My daughter takes a SSRI and it helps a lot. Alcohol appears to be helpful for some (not so great for chronic treatment though).

Others have tried diet modification and nutrient supplements of various types. I haven’t really heard enough compelling examples for me to be motivated to try these with my daughter.

There is an audiologist based misophonia treatment protocol that Dr. Johnson and others have tried and are collecting data on. I think this involves counseling and the use of in ear noise generators to help mask trigger sounds.

I’m really sorry we can’t point you to anything with more confidence. Unfortunately there is mostly anecdotal evidence with very little in the way of careful scientific studies. Personally, I try to evaluate potential treatments from an evidence based scientific perspective. I am not going to try things that I can’t imagine a plausible mechanism for working (unless there is a flood of people reporting success). NFB barely crossed the threshold for me in that there is a plausible mechanism of action, and a barely compelling amount of evidence in the scientific literature of it having efficacy in other pathologies. Tom Dozier’s approach to misophonia treatment seems reasonable and I like that he is interested in objectively evaluating its efficacy.

Good luck.