A Systematic Review on the Pharmacological Treatment of Delusional Disorder.
BACKGROUND
Pharmacological treatment is the criterion standard in delusional disorder (DD). No second-generation antipsychotic (SGA) is specifically authorized for the treatment of DD.


OBJECTIVE
To evaluate the evidence available on pharmacological treatments in adults with DD and to compare first-generation antipsychotics (FGA) versus SGA.


METHODS
A systematic review on pharmacological treatment of DD following the PRISMA methodology was conducted. We selected the best evidence available and analyzed it critically assessing both, biases and quality, to finally perform a narrative and quantitative synthesis.


RESULTS
The evidence available was mainly limited to observational studies and case series. There were no randomized clinical trials. Three hundred eighty-five DD cases were included (177 of which were on SGAs). Overall, antipsychotics achieved a good response in 33.6%% of the patients. As a group, FGAs showed significant superiority compared to SGAs (good response rates were 39% vs 28%, respectively). We did not find superiority of any specific antipsychotic over another.


CONCLUSIONS
There is no strong evidence to make definite recommendations, although antipsychotics in general seem to be an effective treatment for DD with a slight superiority in favor of FGAs as compared with SGAs. Existent data are, albeit, scarce and specific clinical trials on DD, are strongly recommended.
From the Mental Health Unit, Granada University Hospital, Andalusian Health Service, CIBERSAM, University of Granada, Granada, Spain.
José Eduardo
JE
Muñoz-Negro
Jorge A
JA
Cervilla
D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003702:Delusions / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome
D014150:Antipsychotic Agents