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Successful Treatment of Delusions of Parasitosis With Olanzapine
William J. Meehan, MD, PhD;
Sonia Badreshia, MD;
Christine L. Mackley, MD
Arch Dermatol. 2006;142:352-355.
Background Delusional parasitosis is a rare disorder in which patients have a fixed, false belief of being infested with parasites. It is often accompanied by a refusal to seek psychiatric care. Delusions of parasitosis is classically treated with typical antipsychotic agents, the traditional dermatologic choice being pimozide. However, pimozide's adverse effect profile and the need for frequent electrocardiographic monitoring make such treatment less practical.
Observation We describe 3 patients who were diagnosed as having delusional parasitosis that was successfully treated with a recently Food and Drug Administration–approved atypical antipsychotic agent, olanzapine (5 mg/d). Olanzapine has a more benign adverse effect profile than typical antipsychotic agents and eliminates the need for electrocardiographic monitoring. Olanzapine therapy has been associated with such adverse effects as sedation, hyperlipidemia, weight gain, and insulin resistance, all of which were infrequent in our patients.
Conclusion Olanzapine is an atypical antipsychotic agent that can be used as a first-line agent in delusional parasitosis as a safer therapeutic option without a specialized monitoring regimen.
Author Affiliations: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pa.
RELATED LETTER
Pimozide at Least as Safe and Perhaps More Effective Than Olanzapine for Treatment of Morgellons Disease
Caroline S. Koblenzer
Arch Dermatol. 2006;142(10):1364.
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RELATED ARTICLE
Women's Dermatologic Diseases, Health Care Delivery, and Socioeconomic Barriers
June K. Robinson and Marcia Ramos-e-Siliva
Arch Dermatol. 2006;142(3):362-364.
EXTRACT
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Pimozide at least as safe and perhaps more effective than olanzapine for treatment of morgellons disease.
Koblenzer
Arch Dermatol 2006;142:1364-1364.
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Women's Dermatologic Diseases, Health Care Delivery, and Socioeconomic Barriers.
Robinson and Ramos-e-Siliva
Arch Dermatol 2006;142:362-364.
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