olanzapine and Delusional-Parasitosis

Delusional parasitosis (DP) is one type of psychotic disorders. It is a multifactorial disorder with different etiologies. Given that very little attention is paid to entomological survey in these cases, a comprehensive study was designed and performed for the first time in Iran on a suspected DP case and its home from Shiraz during 2018-2019.. In this study, entomological survey, dermatological studies, and psychological and psychiatric interventions were done respectively on a 40-year-old man who was referred to as a suspected case of DP.. No medical importance arthropods were collected from the patient's home. He was not infected with lice and other ectoparasites. Skin samples were negative for scabies, but he was infected with Demodex folliculorum at low level. Psychiatric studies showed that he was a secondary DP case with depression. No effect and partial remission were reported after treatment with risperidone (2-6 mg/d) and olanzapine (5 mg/d), respectively. Therapeutic effects of hypnotism were also not satisfactory.. In Iran, the most important challenges these patients faced with are as follows: the absence of a specific referral center, patients resort to self-treatment or traditional methods, and lack of a certain duration and dosage of antipsychotic for these cases. Comprehensive clinical trials should be done on this rare syndrome at the national level for better understanding the epidemiological profile of DP and finding the best method of treatment for Persian community.

Topics: Adult; Antipsychotic Agents; Delusional Parasitosis; Humans; Iran; Male; Olanzapine; Risperidone

Monosymptomatic hypochondriac psychosis (MHP) patients present with a delusional ideation that revolves around one particular hypochondriac concern. Delusional infestation is the most common type of MHP seen by the dermatologist.. This study was designed to retrospectively investigate a group of patients with delusions of infestation seen in an academic medical center in São Paulo, Brazil.. A retrospective study of patients presenting with delusional infestation between 2007 and 2014 was conducted. Records were reviewed to study personal data, symptoms, and treatments.. Thirty patients were studied (22 female, eight male). Their mean age was 58 years in men and 60 years in women. Twenty-four patients spent most of their time at home (i.e. they were housewives, retired, or unemployed). The duration of disease varied from 3 months to 20 years. Fifteen patients brought in fragments of material that they believed to be parasites ("specimen sign"). Treatment consisted of the antipsychotic drugs pimozide (1-6 mg/d) or olanzapine (5-10 mg/d). Three patients did not return for follow-up. Follow-up varying from 2 months to 7 years was recorded in 24 patients. Two patients were treated with other psychoactive drugs prescribed by psychiatrists for additional psychiatric diagnoses. Control of symptoms was achieved in the majority of patients who underwent adequate follow-up.. Delusional infestation is an extremely chronic disease. Attempts to discontinue treatment in those patients in whom a lengthy follow-up was performed inevitably resulted in symptom relapses.

Topics: Academic Medical Centers; Adult; Age Distribution; Aged; Antipsychotic Agents; Benzodiazepines; Brazil; Chronic Disease; Cohort Studies; Delusional Parasitosis; Dermatology; Ectoparasitic Infestations; Female; Humans; Male; Middle Aged; Olanzapine; Pimozide; Prevalence; Prognosis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Urban Population

Topics: Acanthamoeba; Antipsychotic Agents; Benzodiazepines; Delusional Parasitosis; Dermoscopy; Humans; Male; Middle Aged; Olanzapine; Physician-Patient Relations; Prurigo; Schizophrenia, Paranoid; Skin; Treatment Outcome