If you started (or increased) pregabalin (Lyrica) and suddenly began “hearing” music that isn’t actually playing, you are not alone. The most common name for this experience is musical hallucinations—sometimes called musical hallucinosis or Musical Ear Syndrome. It can feel unsettling, but in many cases it is a medication-related effect and is reversible once the trigger is addressed.
Important: Do not stop pregabalin abruptly unless a clinician tells you to. Pregabalin may need a taper to reduce withdrawal symptoms. If you feel unsafe, confused, severely agitated, or are having thoughts of self-harm, seek urgent help immediately.
What Is “Phantom Music” Called?
The clinical terms most often used include:
- Musical hallucinations (hearing songs, melodies, choir-like sounds, or instrumentals with no external source)
- Musical hallucinosis (often used when the person recognizes the music is not real)
- Musical Ear Syndrome (commonly used when hearing changes or tinnitus contribute)
- Medication-induced auditory hallucinations (a broader category that can include music)
Why Can Pregabalin Trigger Phantom Music?
Pregabalin affects nerve signaling by modulating certain calcium channels in the nervous system. In susceptible people, this can shift how the brain processes sound, especially in quiet environments. When the brain isn’t receiving “enough” clean auditory input (or when signaling is altered), it can “fill in the gaps”—sometimes producing patterned sound that the brain interprets as music.
Key point: Many people with musical hallucinations have intact insight—they know the music isn’t really there. This is often different from psychotic illness and can be related to medication effects, hearing changes, tinnitus, sleep deprivation, or stress.
Common Triggers That Increase Risk
Musical hallucinations tend to be more likely when one or more of these are present:
- Dose changes (starting pregabalin, increasing dose, or sometimes reducing/withdrawing too quickly)
- Hearing issues (mild hearing loss, earwax, ear infections, chronic sinus or Eustachian tube issues)
- Tinnitus (ringing, buzzing, humming—especially when the environment is quiet)
- Sleep deprivation or irregular sleep
- High stress, anxiety spikes, or sensory overload
- Other nervous system-active meds (sedatives, some antidepressants, stimulants, certain pain medications)
- Neurologic vulnerability (rarely: seizure disorders, temporal lobe irritation, migraine variants)
How to Describe It to Your Doctor (Useful “Chart Language”)
If you’re posting for advice or preparing to call your clinician, these phrases can help:
- “New-onset musical auditory hallucinations after starting/increasing pregabalin.”
- “I have insight; I recognize the music is not real.”
- “It’s worse in silence/nighttime.”
- “No confusion, no paranoia, no command voices” (if true).
When to Treat This as Urgent
Seek urgent medical evaluation (same day) if any of the following apply:
- Severe confusion, disorientation, or sudden personality change
- Hallucinations that are frightening, commanding, or include threatening voices
- Fever, stiff neck, severe headache, fainting, new weakness, or seizure
- Recent head injury
- Suicidal thoughts, panic you cannot control, or inability to sleep for 24–48 hours
Medication safety: If this started right after a pregabalin dose increase, contact the prescriber promptly. They may recommend a dose adjustment, a slower titration, or an alternative medication. Do not make changes without medical guidance.
Practical Next Steps That Often Help
1) Reduce “silence” (sound enrichment)
Phantom music often intensifies in quiet rooms. Many people get relief by adding gentle, neutral sound:
- Fan noise, air purifier, or low-level “brown noise”
- Soft spoken podcasts at low volume
- Quiet background music you control (ironically, real music can reduce the brain’s urge to “invent” it)
2) Check the ears and sinuses
If you have congestion, pressure, ear popping, tinnitus, or chronic sinus issues, consider addressing basic contributors (with clinician guidance):
- Earwax impaction check (a very common, overlooked trigger)
- Allergy management if relevant
- Hydration and humidification (dry winter air can worsen Eustachian tube dysfunction)
3) Stabilize sleep for 3–7 nights
Sleep loss is a powerful amplifier. Even one “reset” night can reduce symptoms. Consider:
- Consistent bedtime/wake time
- Low light in the evening; reduce screens late at night
- Magnesium-rich foods at dinner (leafy greens, pumpkin seeds) if tolerated
4) Track pattern + timing (this helps your clinician)
For 3–5 days, jot down:
- Pregabalin dose + time taken
- When the phantom music starts/stops
- Stress level, sleep hours, caffeine, alcohol
- Ear/sinus symptoms (pressure, ringing, muffled hearing)
Earth Clinic-Style Discussion: What Readers Often Ask
- “Is this a sign of brain damage?”
Usually not. In many cases it is related to medication effects, hearing changes, or nervous system sensitivity. Still, new symptoms deserve medical review.
- “Does it go away?”
Often, yes—especially when the trigger (dose change, sleep deprivation, hearing issue) is corrected.
- “Should I stop the medication today?”
Do not stop abruptly unless told to. Call the prescriber to discuss a safer plan.
Gentle, Low-Risk Support Options (Non-Drug)
Earth Clinic readers often prefer conservative, low-risk steps that can be used alongside medical advice. Here are options that are generally reasonable to consider, depending on your situation:
Supportive basics:
- Hydration (especially if dry air or congestion is a factor)
- Balanced blood sugar (regular meals can reduce “wired” sensations at night)
- Limit stimulants (caffeine, nicotine) for a week
- Gentle sound enrichment at bedtime
Note: If you are sensitive to supplements or your clinician asked you to pause supplements, focus on the non-supplement steps above first.
If you’ve experienced phantom music or auditory changes on pregabalin (or another medication), what helped most? Include your dose, timing, whether you had tinnitus/hearing issues, and how long it took to improve.
