Treatment of self-mutilation with olanzapine.
BACKGROUND
Self-mutilation or dermatitis artefacta is a facet of a much broader spectrum of factitial disease. Three nonpsychotic patients with self-mutilation are presented in this article who were successfully treated with low dose olanzapine when all other modalities of therapy had failed, including trials with numerous antidepressants and antipsychotics.


OBJECTIVE
The patients were simultaneously evaluated and treated by a dermatologist and a psychiatrist who run the psychodermatology or consultation-liaison clinic based at McMaster University. After dermatologic conditions had been excluded as a cause of the clinical findings, olanzapine was prescribed on a trial basis due to its low risk of parkinsonian side-effects and its antihistaminic properties.


CONCLUSIONS
The excellent clinical response of the patients can be attributed to the low side-effect profile of the drug but also to the anti-impulsive effect which stems not only from antihistaminic properties but also from its antidopamine and serotonin-blocking action.
Garnis-Jones
S
S
Division of Dermatology, Department of Medicine and the Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
Collins
S
S
Rosenthal
D
D
D000328:Adult; D001569:Benzodiazepines; D003872:Dermatitis / Q000188:drug therapy / Q000523:psychology; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D055502:Secondary Prevention; D012652:Self Mutilation / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D001569:Benzodiazepines; D000077152:Olanzapine; D010890:Pirenzepine; D017367:Selective Serotonin Reuptake Inhibitors