Treatment of Delusional Infestation with Olanzapine

Kansal, Naveen Kumar; Chawla, Omna; Singh, Gurvinder

doi:10.4103/0253-7176.106043

Cited by 3 publications

(2 citation statements)

References 3 publications

(11 reference statements)

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“…The mean age of onset in recent reports (Table 1) was older than 45 years. Further, in our summary of 25 individuals [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27], women became ill significantly later than men which is consistent with other recent studies [2••, 7••, 12••] and some previous ones [10]. Since DD appears to be a disorder mostly seen in later stages of life, physicians and caregivers should be cautious about medication side effects and drug-drug interactions when it comes to pharmacological treatment.…”

Section: Psychopharmacological Treatment Methodssupporting

confidence: 90%

Current Treatments for Delusional Disorder

Roudsari¹,

Chun

Manschreck

2015

Curr Treat Options Psych

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Delusional disorders form part of the spectrum of psychotic disorders in psychiatry. They are poorly understood in practically every aspect of their nature, including cause, phenomenology, prevalence, comorbidity, course, treatment, and prognosis. The key symptom in delusional disorders is one or more delusions. A cardinal characteristic of delusional disorder, conviction that one is not mentally ill, contributes complexity to the treatment challenges and profoundly affects the therapeutic relationship. Diagnosis and differential diagnosis are critical tasks. Delusional conditions may arise from many sources and, only when the case conforms to the criteria and is clearly idiopathic-is a primary delusional disorder-can we feel confident that the patient suffers from delusional disorder rather than a secondary delusional condition. Adequate treatment follows principles for the treatment of delusions. First line pharmacological treatment for delusional disorder is antipsychotic medication, both first and second-generation agents, and some evidence suggests that clozapine may be effective in certain cases. The assumption in such a formulation is that the delusion(s) encountered in delusional disorders respond as a class of symptoms found in different disorders. Hence, the approach for failed interventions with these agents may be similar to that proposed for the treatment of schizophrenia or other psychotic disorders. Namely, searching for evidence of failure to take medication, inadequate dosing, a missed diagnosis of a substance disorder, medical condition, or even another psychiatric disorder should be considered. For individuals with delusional disorders who are also experiencing comorbid depression or anxiety, the addition of appropriate agents for those symptoms may provide a synergistic strategy for overall effectiveness. Psychotherapy is another important clinical tool. Cognitive behavioral therapy focusing on different aspects of delusions (i.e., anxiety, reasoning biases, faulty logic, etc.) has demonstrated some value for at least short-term improvement. Various techniques may be useful in allying with the patient and supplying means to assist in managing their thinking and approach to circumstances and factors that promote delusion formation and encourage actions taken to respond. A significant problem in applying what we know about delusional disorders to treatment is the limited available evidence. Lack of randomized controlled trials, which form the standard in most clinical disorders, is a major shortcoming. Recent observations of compromised cognitive functioning in working memory, attention, and executive function should be replicated with similar standards. Systematic case studies and large series are useful, and a growing effort to be more rigorous methodologically in all contributions including case registries and longer followup studies is promising. Nevertheless, our knowledge remains less than optimal. These comments apply not only to pharmacological observations but also to those of neuropsyc...

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Section: Psychopharmacological Treatment Methodssupporting

confidence: 90%

Current Treatments for Delusional Disorder

Roudsari¹,

Chun

Manschreck

2015

Curr Treat Options Psych

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“…This condition can be affected by a large array of complications as listed in Table 3 (6,12,35). The recommended treatments are based on anti-psychotic medication such as risperidone, pimozide (36,46), olanzapine, amilsupride, quetiapine and aripiprazole (47)(48)(49)(50). Atypical anti-psychotics have a more favorable side-effect profile (50).…”

Section: Drugs or Conditionsmentioning

confidence: 99%

Delusional infestation. Ekbom´s syndrome in a 47-year-old woman. Case report

Olivera¹,

Villamil²,

Moreno³

et al. 2017

Case reports

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Introduction: Delusional infestation is a rare psychiatric disorder defined as a condition in which the patient has the unshakable belief and perception of being infested with parasites. Its treatment is difficult, and frequently includes antipsychotic medications (such as olanzapine or aripiprazole). Non-pharmacological treatment, particularly psychotherapy, can be used for less severe cases. Dermatologists and psychiatrists must take a multi-disciplinary approach (preferably in a psycodermatology dedicated clinic) since this type of patients sometimes refuse treatment. Case description:A 53-year-old female businesswoman describes a clinical history of five years of visual hallucinations, depressive symptoms, and generalized pruritus, along with the use of toxic substances to "clean" her skin and cloths. She reports similar symptoms in some relatives but they were not evaluated. Blood tests and analyses of the "specimen" brought by the patient were performed, yielding negative results. The patient had never been assessed by any specialist, and showed disoriented during the consultation. Follow-up was not possible due to the reluctance of the patient to follow the indications and seek psychiatric treatment. Moreover, the patient did not respond to further communication attempts.

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Reframing delusional infestation: perspectives on unresolved puzzles

Lai

et al. 2018

PRBM

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Delusional infestation (DI), a debilitating psychocutaneous condition, featured as a false fixed belief of being infested accompanied by somatosensory abnormality, behavior alteration, and cognitive impairment. Although management of primary causes and pharmacotherapy with antipsychotics and/or antidepressants can help to alleviate symptoms in most patients, the underlying etiology of DI still remains unclear. Morgellons disease (MD), characterized by the presence of cutaneous filaments projected from or embedded in skin, is also a polemic issue because of its relationship with spirochetal infection. This review aims to discuss the following topics that currently confuse our understandings of DI: 1) the relationship of real/sham “infestation” with DI/MD; 2) behavior alterations, such as self-inflicted trauma; 3) neuroimaging abnormality and disturbance in neurotransmitter systems; and 4) impaired insight in patients with this disease. In discussion, we try to propose a multifactorial approach to the final diagnosis of DI/MD. Future studies exploring the neurobiological etiology of DI/MD are warranted.

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Treatment of Delusional Infestation with Olanzapine

Cited by 3 publications

References 3 publications

Current Treatments for Delusional Disorder

Current Treatments for Delusional Disorder

Delusional infestation. Ekbom´s syndrome in a 47-year-old woman. Case report

Reframing delusional infestation: perspectives on unresolved puzzles

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