Kompendium der Psychiatrischen Pharmakotherapie

Benkert, O.; Hippius, Hanns

doi:10.1007/978-3-662-12174-0

Cited by 104 publications

(173 citation statements)

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“…No substance is specifically approved for treating DI or the overarching categories "delusional disorder, somatic type," or "delusional disorder." Only some typical antipsychotics, with their often-broader approval, might cover DI, e.g., haloperidol and fluphenazine (28,305). In contrast, most atypical antipsychotics have explicit approval only for "acute therapy" and/or "maintenance treatment of schizophrenia" in most countries.…”

Section: Treatment Goalsmentioning

confidence: 99%

“…Final remarks on pimozide. Pimozide is no longer a first-line antipsychotic for any indication (schizophrenia or tic disorder) for reasons of drug safety, according to the FDA and other authorities (28,305). This reassessment largely results from a high risk of a QTc prolongation and hepatic drug-drug interactions (mainly via CYP 3A4).…”

Section: Antipsychotic Therapy Of DImentioning

confidence: 99%

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Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

227

367

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SUMMARY This papers aims at familiarizing psychiatric and nonpsychiatric readers with delusional infestation (DI), also known as delusional parasitosis. It is characterized by the fixed belief of being infested with pathogens against all medical evidence. DI is no single disorder but can occur as a delusional disorder of the somatic type (primary DI) or secondary to numerous other conditions. A set of minimal diagnostic criteria and a classification are provided. Patients with DI pose a truly interdisciplinary problem to the medical system. They avoid psychiatrists and consult dermatologists, microbiologists, or general practitioners but often lose faith in professional medicine. Epidemiology and history suggest that the imaginary pathogens change constantly, while the delusional theme “infestation” is stable and ubiquitous. Patients with self-diagnosed “Morgellons disease” can be seen as a variation of this delusional theme. For clinicians, clinical pathways for efficient diagnostics and etiology-specific treatment are provided. Specialized outpatient clinics in dermatology with a liaison psychiatrist are theoretically best placed to provide care. The most intricate problem is to engage patients in psychiatric therapy. In primary DI, antipsychotics are the treatment of choice, according to limited but sufficient evidence. Pimozide is no longer the treatment of choice for reasons of drug safety. Future research should focus on pathophysiology and the neural basis of DI, as well as on conclusive clinical trials, which are widely lacking. Innovative approaches will be needed, since otherwise patients are unlikely to adhere to any study protocol.

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Section: Treatment Goalsmentioning

confidence: 99%

Section: Antipsychotic Therapy Of DImentioning

confidence: 99%

Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

227

367

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“…Psychotropic medication use was categorized for statistical analysis as follows: regular vs on-demand use, antipsychotic medication by potency, 27 typical vs atypical, chemical structure, and all regular medication used by any patients by immunomodulatory potency according to human in vivo data (yes = amitriptylline, 28 carbamazepine, 29 clozapine, 28 lithium, 28,29 mirtazapine, 30 and olanzapine 28 ; no = haloperidol, 28 paroxetin, 28 and venlafaxin 30 ; and unknown/possible immunomodulation = amisulpride, flupenthixol, levomepromazine, melperone, perazine, perphenazine, pipamperone, promethazine, quetiapine, risperidone, and ziprasidone, with respect to antipsychotics).…”

Section: Methodsmentioning

confidence: 99%

A controlled prospective study of Toxoplasma gondii infection in individuals with schizophrenia: Beyond seroprevalence

et al. 2007

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Toxoplasma gondii (TG) infection has been reported to be more frequent in schizophrenia. The interaction of the lifelong persisting parasite with the host's immune system involves T-cell/interferon-gamma-induced degradation of tryptophan and provides a challenge to the host well beyond a possible role in the etiology of schizophrenia. The hypothesis we tested in this study was that TG infection may be more frequent (serofrequency) and/or more intense (serointensity) in patients with schizophrenia or major depression compared with psychiatrically healthy controls. In addition, these measures are associated with the clinical course. We did a cross-sectional, prospective investigation of individuals with schizophrenia (n = 277) and major depression (n = 465) admitted to our department (2002)(2003)(2004)(2005) and of healthy controls (n = 214), with all groups adjusted for age and geographic home region. Serofrequency was comparable between the groups, but serointensity was significantly higher in the patients. In individuals with schizophrenia, serointensity was significantly positively associated with C-reactive protein levels and leukocyte counts, and firstepisode patients yielded significantly higher serotiters. Immunomodulatory medication was associated with decreased serotiters. In addition, the route of infection appears to differ between patients and controls. Thus, our results support increased host responses to TG infection in the patients, as well as increased titers in first-episode patients with schizophrenia; this may relate to the shifted T-helper 1/2 status described in these patients. Therefore, we suggest that TG infection, particularly in individuals with schizophrenia, is an important environmental factor in the interaction between psychiatric vulnerability, genetic background, immunomodulation, and the neurotransmitter systems.

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“…Bei den Antikonvulsiva ist der medikamentöse Erfolg die zentrale Sedierung, bei vielen Antidepressiva ist die Sedierung eine gewünschte Begleitwirkung in der Stabilisierung bei depressiven Episoden, Angststörungen, Panikattacken, bei Entzugssyndromen, Schmerzen, Schlafstörungen und anderen Störungen [6]. Antipsychotika haben eine sedierende und antipsychotische Wirkung, z.…”

Section: » Antikonvulsive Medikamente Können Ein Bestehendes Schluckdunclassified