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Treatments for Primary Delusional Infestation: Systematic Review.

Justin Di Lu1, Ryan D Gotesman2, Shawn Varghese1

  • 1Michael G DeGroote School of Medicine, Hamilton, ON, Canada.

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|August 26, 2023
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Summary
This summary is machine-generated.

Delusional infestation, or Ekbom syndrome, is a rare disorder where patients believe they are infested. First-generation antipsychotics show similar effectiveness to second-generation antipsychotics in treatment.

Keywords:
Morgellons diseaseSSRIantipsychoticatypicaldelusiondelusional infestationdelusional parasitosisdermatologistdermatologydrugpharmacologicalpharmacologypsychiatricrare disordersystematic reviewtreatmenttypical

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Area of Science:

  • Psychiatry
  • Dermatology
  • Pharmacology

Background:

  • Delusional infestation (Ekbom syndrome) is a rare psychiatric disorder characterized by a fixed delusion of infestation.
  • Patients often present with dermatological symptoms, necessitating clear treatment guidelines.
  • The optimal management strategy for primary delusional infestation remains unclear.

Purpose of the Study:

  • To systematically review and describe the treatment and management of patients with primary delusional infestation.
  • To analyze treatment efficacy, dosage, adherence, and side effects based on existing case series.

Main Methods:

  • Systematic literature search conducted across major databases (MEDLINE, Embase, PsycINFO, Cochrane).
  • Data extraction and analysis focused on treatment details, patient response, and adverse events.
  • Inclusion of 15 case series comprising 280 patients diagnosed with delusional infestation.

Main Results:

  • Aripiprazole demonstrated the highest complete remission rate (79%) in a small subset of patients.
  • Selective serotonin reuptake inhibitors (SSRIs) showed high efficacy (79% complete remission) in patients with comorbid anxiety or depression.
  • First-generation and second-generation antipsychotics exhibited comparable complete remission rates (approximately 54% and 48%, respectively).

Conclusions:

  • First-generation antipsychotics appear to be as effective as second-generation antipsychotics for delusional infestation.
  • SSRIs may be beneficial for patients with comorbid psychiatric conditions.
  • Larger studies and randomized controlled trials are essential to confirm the efficacy of pharmacological treatments.