Paliperidone: another treatment option for delusional parasitosis (original) (raw)
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Atypical Antipsychotic Drugs in the Treatment of Delusional Parasitosis
International Journal of Psychiatry in Medicine, 2007
Introduction: Delusional parasitosis (DP) is a rare delusional disorder in which patients believe that they are infected with parasites, worms, insects, or bacteria. Antipsychotics are the preferred treatment in these patients. Method: Case series in which we summarize six patients with DP treated with atypical antipsychotic medications including amisulpride, olanzapine, and risperidone. Results: One patient had a myocardial infarction after being given amisulpride, and several patients did not adjust well. Parenterally administered antipsychotics, particularly risperidone, were the most effective treatment in this series of patients with DP. Conclusion: Patients with DP can be difficult to treat; however, parenterally administered antipsychotics appear to produce better results in these patients.
Antipsychotic treatment of primary delusional parasitosis
British Journal of Psychiatry, 2007
BackgroundLittle is known about the treatment of delusional parasitosis with typical and atypical antipsychotics.AimsTo evaluate the effectiveness of typical and atypical antipsychotics in primary delusional parasitosis (delusional disorder, somatic type).MethodA systematic review was conducted.ResultsNo randomised trials were found and hence we collected the best evidence from 16 other trials and case reports, separating primary from other forms of delusional parasitosis. Studies using typical antipsychotics showed partial or full remission in between 60 and 100% of patients. Analysis of selected patients with primary delusional parasitosis showed that typical and atypical antipsychotics were effective in the majority, but that remission rates did not differ significantly between typical and atypical antipsychotics.ConclusionsIn the absence of controlled trials there is limited evidence that antipsychotics are effective in primary delusional parasitosis. Rigorous studies are needed...
Atypical anti-psychotics in Delusional Parasitosis: a retrospective case series of 20 patients
International Journal of Dermatology, 2010
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.
International Journal of Dermatology, 2010
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.
Successful Ziprasidone Monotherapy in a Case of Delusional Parasitosis: A One-Year Followup
Case Reports in Psychiatry, 2013
Delusional parasitosis is characterized by the false idea that own body is infested by invisible mites, insects, or other parasites. This case report describes a 24-year-old woman with delusional parasitosis who was treated with ziprasidone monotherapy (120 mg/day) with a complete remission of delusion and followed for one year without symptom recurrences. These findings, although preliminary, indicate that further investigation of ziprasidone monotherapy for the treatment of delusional parasitosis is warranted in further trials.
Ziprasidone in the Treatment of Delusional Parasitosis
Case Reports in Dermatology, 2012
This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License (www.karger.com/OA-license), applicable to the online version of the article only. Distribution for non-commercial purposes only.
Primary delusional parasitosis treated with olanzapine
International Psychogeriatrics, 2007
Delusional parasitosis (DP) is a rare psychiatric disorder, predominantly observed in middle aged and elderly patients. It can manifest itself as an isolated delusional disorder (primary DP), as a symptom of another psychiatric disorder or as an organic or toxic psychosis. The typical antipsychotic pimozide was traditionally considered to be the gold standard for treating DP. Compared with pimozide, atypical antipsychotics have many advantages in terms of tolerability, but their effectiveness has only been shown in a few case reports, which do not differentiate between primary and other forms of DP. We present the case of a 77-year-old woman with primary DP who responded markedly to the atypical antipsychotic olanzapine (2.5 mg daily). She was treated in a psychiatric outpatient department with a follow-up period of 3.5 years. This is the first report of a successful olanzapine mono-therapy in primary DP in such a setting and the longest follow-up period ever reported. The need for maintenance treatment was demonstrated. Olanzapine in age-adapted doses should be considered as an alternative treatment. This paper also provides a review of all published cases in which primary DP was treated with atypical antipsychotics.
Second-Generation Antipsychotics in Primary and Secondary Delusional Parasitosis
Journal of Clinical Psychopharmacology, 2008
In the absence of controlled clinical trials, little is known about antipsychotic treatment in primary and secondary delusional parasitosis (DP). All available data on the efficacy of antipsychotics (APs) and the outcome in DP date back to the era of first-generation antipsychotics, whereas such data are lacking for second-generation antipsychotics (SGAs). To study outcome and efficacy of SGAs in all forms of DP by means of a case-based analysis, we extracted 63 cases from 434 available publications and assessed them by 2 independent raters using standardized criteria for efficacy and outcome. The time course of response and the SGA doses used in DP were also first studied. The sample was comparable to classic samples and comprised mainly secondary DP cases (56%). The median onset of effect occurred after 1.5 weeks, and the maximum effect occurred after 6 weeks (later in primary than secondary DP, 10 vs 3 weeks; P < 0.004). If a treatment of more than 8 weeks could be established, all cases responded at least partially. In the outcome analysis, partial or full remission was performed by 75% of cases (final outcome, therapy switches allowed). In the efficacy analysis, partial or full remission was reached in 69% of the situations when an SGA was introduced (without therapy switches). Secondary DP was more likely to respond to SGAs than primary DP (78% vs 59% trend). Risperidone and olanzapine were most widely used and resulted in full or partial remission in 69% and 72%, respectively. Doses were lower than those used in schizophrenia. This first retrospective case-based study provides low-level evidence that SGAs are effective in DP and that outcome is favorable, although a publication bias is likely. Our findings need to be confirmed by controlled trials.
Aripiprazole as a treatment option for delusional parasitosis: case series of 8 patients
Psychiatry and Clinical Psychopharmacology
Objective: Delusional parasitosis (DP), also known as Ekbom's Syndrome, is a rare, generally monosymptomatic disorder that characterizes with the fixed belief of being infected by parasites without any evidence of medical or microbiological proof. These patients are examined in dermatology and infection clinics with symptoms and signs of pruritus, skin and subcutaneous scars secondary to itching. Primary DP is diagnosed when no etiological factor is detected while secondary DP arises from underlying physical or mental disorder. Formerly, pimozide was the commonly preferred choice of treatment with cases of DP. However, there is growing evidence that second-generation antipsychotics and antidepressants can be used in the treatment of DP. In this study, the usage of aripiprazole in the treatment of DP cases is presented. Methods: 8 patients with the diagnosis of primary DP were evaluated in terms of demographic data, clinical variables and responses to treatment. A psychiatric diagnosis was made based on a clinical interview performed using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) SCID-I. The patients were followed for six months. Three patients were female, five patients were male. The average age of the patients was 57.5. Four patients had essential hypertension as comorbidity. The duration of the symptoms ranged from 6 to 48 months with an average of 24.75 months. All of our 8 cases were consulted by the dermatology department. The patients were performed Hamilton Depression Scale (HDS) and Mini-Mental Status Examination (MMSE). Eight patients were treated with aripiprazole 10 or 15 mg/day, and no dose alteration was made. Results: From the patients who were treated with aripiprazole, seven (87.5%) patients had complete remission after three months, eight (100%) patients achieved complete remission after six months. Discussion: The earliest drug choice for patients with DP was pimozide, but because of the extrapyramidal side effects and cardiac side effects like QTc prolongation, second-generation antipsychotics are being investigated for treatment. Various researches are available related to the usage of second-generation antipsychotics like risperidone, olanzapine, paliperidone, ziprasidone, quetiapine, and aripiprazole in the cases with DP. This study shows that aripiprazole can be a successful treatment choice for DP, but further studies are needed for this topic.
A delusional parasitosis case responding to low dose risperidone treatment
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2016
A delusional parasitosis case responding to low dose risperidone treatment Delusional parasitosis is a somatic type delusional disorder encountered in presenile women who suffer from a fixed false belief that they are infested with parasites. Despite a detailed examination and assurance, patients are not convinced that they have no parasitic infection. Repetitive applications and tests increases the treatment cost very much. In this article, we present a 76 years-old woman who had persistent thoughts about being infested by parasites for two years, and made deep scars widely distributed on her body, and was refusing any psychiatric diagnosis. Our aim was to draw attention to the delusional disorder which was a rare disease with poor prognosis, and to report results of low dose risperidone treatment with favorable outcomes of given psycho-education to the patient and her family.