Atypical anti-psychotics in delusional parasitosis: a retrospective case series of 20 patients

Int J Dermatol. 2010 Jan;49(1):95-100. doi: 10.1111/j.1365-4632.2009.04312.x.

Abstract

Background: Delusional Parasitosis (DP) is a relatively uncommon condition wherein there is a fixed belief that one is infested with living organisms despite a lack of medical evidence of such infestation. Pimozide has been mooted as specific for the treatment of this condition. Atypical anti-psychotics have received attention in recent years.

Methods: We describe the clinical features and treatment responses in a retrospective review of 20 cases treated at this department over a 5 year period, and selectively review the literature.

Results: The majority were treated with atypical anti-psychotics and all subjects who followed up showed varying degrees of clinical improvement irrespective of the anti-psychotic used.

Conclusion: The evidence for pimozide as first line drug in DP is limited to one small, non-randomized placebo-controlled trial. DP responds well to most anti-psychotics. Prospective randomized trials are needed to clarify optimal treatment of this relatively rare but debilitating condition.

MeSH terms

  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Benzodiazepines / administration & dosage
  • Benzodiazepines / adverse effects
  • Ectoparasitic Infestations / psychology*
  • Female
  • Fluoxetine / administration & dosage
  • Fluoxetine / adverse effects
  • Haloperidol / administration & dosage
  • Haloperidol / adverse effects
  • Humans
  • Imipramine / administration & dosage
  • Imipramine / adverse effects
  • Male
  • Middle Aged
  • Olanzapine
  • Pimozide / administration & dosage*
  • Pimozide / adverse effects
  • Retrospective Studies
  • Risperidone / administration & dosage
  • Risperidone / adverse effects
  • Schizophrenia, Paranoid / drug therapy*
  • Sertraline / administration & dosage
  • Sertraline / adverse effects

Substances

  • Antipsychotic Agents
  • Fluoxetine
  • Benzodiazepines
  • Pimozide
  • Haloperidol
  • Risperidone
  • Olanzapine
  • Imipramine
  • Sertraline