Pharmacologic treatment of body dysmorphic disorder

Body dysmorphic disorder (BDD), a preoccupation with an imagined or slight defect in appearance, has been described for more than a century and reported around the world. However, investigation into the treatment of this distressing and impairing disorder is just beginning. Available data on the pharmacologic treatment of BDD suggest that it often responds to serotonin reuptake inhibitors (SRIs), which may be preferentially effective for this disorder. Augmentation of SRIs with buspirone and neuroleptics, as well as combinations of SRIs, also appear promising. Available data also suggest that serotonin reuptake inhibitors may be effective for delusional BDD (a type of delusional disorder, somatic type). Because controlled treatment studies are lacking, however, these findings are preliminary. Controlled pharmacotherapy studies, which are under way, are greatly needed.