Pimozide in the treatment of monosymptomatic hypochondriacal psychosis

An account is given of six cases treated with pimozide. Four of there cases fall into the diagnostic category of monosymptomatic hypochondriacal psychosis, a group with a traditionally poor prognosis. Three out of the four have responded favourably to pimozide, while the fourth showed a partial improvement. A fifth case also showed a marked degree of improvement despite a possibility of early cerebral arteriopathy. The one case which showed no improvement was suspected all along of having a personality disorder rather than a psychotic illness, and this was subsequently confirmed. It is suggested that pimozide: a) may be an effective treatment for monosymptomatic hypochondriacal psychoses whatever their aetiology; and b) may differentiate rapidly between cases of monosymptomatic hypochondriacal psychoses and dysmorphophobias due to neurotically determined factors.