Secondary delusional parasitosis treated with paliperidone.
Second-generation antipsychotics (SGA) are increasingly used in primary and secondary delusional parasitosis (DP) because of their better overall tolerability compared with first-generation antipsychotics (FGA) such as pimozide. Controlled clinical trials with antipsychotics in DP are lacking, owing to difficulties in obtaining informed consent and in securing adherence to a study protocol by patients with DP. We present the case of an 88-year-old man with a 12-year history of DP secondary to leucoencephalopathy. After 9 days of an age-adapted dose of paliperidone, the patient no longer experienced the presence of vermin on his skin and stopped showering at night to get rid off of them. Paliperidone was well tolerated. At follow-up after 2 weeks, the DP was still remitted. Paliperidone appears to expand the therapeutic arsenal in treating DP with modern SGAs; however, this finding needs to be replicated.
Freudenmann
R W
RW
Department of Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
Kühnlein
P
P
Lepping
P
P
Schönfeldt-Lecuona
C
C
D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001927:Brain Diseases / Q000523:psychology; D004478:Ectoparasitic Infestations / Q000523:psychology*; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D000068882:Paliperidone Palmitate; D011743:Pyrimidines / Q000627:therapeutic use*; D012563:Schizophrenia, Paranoid / Q000188:drug therapy* / Q000209:etiology
D014150:Antipsychotic Agents; D007555:Isoxazoles; D011743:Pyrimidines; D000068882:Paliperidone Palmitate