Neuroleptic ‘Hyposensitization’ – Therapy for Delusional Parasitosis

Abstract

Neuroleptics are a mainstay in the therapy of delusional parasitosis. We describe a strategy to motivate patients to accept this kind of medicament despite the fact that they usually reject to use psychotropic drugs. We had labeled this motivational strategy ‘hyposensitization’ because we use an injectable depot neuroleptic. The symptoms of the patient are explained as an extreme hypersensitivity of the most peripheral skin nerves. Consequently, this ‘hypersensitivity’ requires a ‘hyposensitization’ akin that in an immediate hypersensitivity reaction (type-I allergy), in their case by a neuroleptic drug, however. Recently, we have used this strategy successfully in a couple with shared delusional parasitosis and in a single patient.

Delusional parasitosis in dermatological practice

“…There is also the possibility of giving depot neuroleptic therapy with flusperilen. This therapy requires injections at regular intervals and there are favourable reports about the clinical effects of this treatment in patients with DP 22 . In some cases antidepressants given additionally may be beneficial.…”

Delusional Parasitosis

“…Bahmer and Bahmer [2002] successfully labeled a treatment with injectable depot neuroleptic drugs as 'hyposensitization' (following the model of the treatment of type-I allergy) to 'motivate' patients suffering from delusional parasitosis to accept an effective pharmacological strategy.…”

“…Depressive slumps and suicidal crises must be expected. The 'hyposensitization' strategy used by Bahmer and Bahmer [2002], is certainly difficult regarding the principle of informed consent as a basis of an ideal therapeutic relationship and vividly illustrates the kind of balance needed in this field.…”