Hypothesis: involvement of the serotonergic system in the clinical expression of monosymptomatic hypochondriasis

Monosymptomatic hypochondriasis, including delusional parasitosis and non-neurotic dysmorphophobia, are disorders which have been observed and recorded over the past century. These disorders occur commonly, and can be associated with significant morbidity. Once ominous of an extremely poor prognosis, there now exists a significant literature to suggest efficacy for pimozide. Taking LSD as a model for 5-HT2 agonist mediated hallucinogenesis, it is possible to draw comparisons to the clinical picture associated with MHP and to identify potent 5-HT2 antagonism as a shared and perhaps requisite criterion for the successful pharmacologic treatment of this disorder. Additional studies are suggested which would add to the understanding of the pathophysiology of MHP.