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A systematic review of antipsychotic agents for primary delusional infestation
Meghan L McPhie1, Mark G Kirchhof2
1School of Medicine, Queen's University, Kingston, ON, Canada.
Background:
Delusional infestation (DI) is a rare delusional disorder in which individuals have a false belief that they are infested with bugs, parasites, or insects, despite the lack of medical evidence that such an infestation exists. Data on the effectiveness of antipsychotics for DI are limited.
Methods:
We conducted a systematic review using EMBASE, MEDLINE, PsycINFO, and Cochrane Central Register of Controlled Trials from inception of the databases up until July 20, 2018. Studies examining typical or atypical antipsychotics for primary DI were included.
Results:
A total of 51 relevant articles were identified, primarily case reports/series. Overall response was favorable for both typical and atypical antipsychotics, but there was no strong evidence to suggest that any one antipsychotic agent was preferable to other agents. Pimozide (1-16 mg/day) and risperidone (0.5-8 mg/day) were the most commonly studied typical and atypical antipsychotics, respectively. Inconsistent reporting of treatment outcomes and variability in study designs limited the overall evaluation of the data.
Conclusions:
There remains a lack of sound data supporting the effectiveness of antipsychotic treatment for primary DI. Further research is required to establish more definitive conclusions about the relative clinical utility of antipsychotic agents for DI.
Insights
Antipsychotics show a favorable response for delusional infestation (DI), a condition where individuals falsely believe they are infested. However, current data is limited, indicating a need for more research on effective treatments for DI.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Delusional infestation (DI) is a rare disorder characterized by a persistent false belief of infestation.
- Medical evidence does not support the presence of parasites or insects in individuals with DI.
- Limited data exists on the efficacy of antipsychotic medications for treating DI.
Purpose of the Study:
- To systematically review the available literature on the effectiveness of antipsychotic medications for primary delusional infestation.
Main Methods:
- A systematic review was conducted using major databases (EMBASE, MEDLINE, PsycINFO, Cochrane).
- Studies published up to July 20, 2018, focusing on typical or atypical antipsychotics for primary DI were included.
Main Results:
- Fifty-one articles, mostly case reports/series, were analyzed.
- Both typical and atypical antipsychotics demonstrated a favorable overall response in patients with DI.
- Pimozide and risperidone were the most frequently studied agents, but no single antipsychotic showed superiority.
- Inconsistent outcome reporting and study design variability limited definitive conclusions.
Conclusions:
- Insufficient high-quality data currently supports the effectiveness of antipsychotic treatment for primary DI.
- Further rigorous research is necessary to determine the optimal antipsychotic agents and their clinical utility for DI.
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