Topiramate-induced delusional parasitosis

Fleury, Vanessa; Wayte, Jeffrey; Kiley, Michelle

doi:10.1016/j.jocn.2006.12.017

Cited by 18 publications

(6 citation statements)

References 6 publications

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“…Case reports on DI are available from all continents except Africa (and the Antarctic). While most classic reports came from Europe and North America, more recently an increasing number of cases from South America (249,258), the Caribbean (80), the Middle East (110,298), Asia, the Pacific Region, and Australia (19,88,187,244) have been published.…”

Section: Epidemiologymentioning

confidence: 99%

Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

230

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: Epidemiologymentioning

confidence: 99%

Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

230

367

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“…Apart from its direct dopaminergic actions at D2-like receptors, our report suggests a participation of central nervous alpha-2 drenoreceptors , most probably by indirect adrenergic and dopaminergic eff ects, in inducing symptoms of substance-induced delusional infesta-tion. Similarly, anecdotal evidence from single cases found an association of non-dopaminergic drugs with symptoms of DI, e. g., antibiotics such as clarithromycin [15] or ciprofl oxacin [16] , corticosteroids [8,17] , cannabis [18,19] , IFN alpha-b2 + ribavirin [20] , and topiramate [21] . The psychotic symptoms seen with quinolone antibiotics such as ciprofl oxacine are usually explained by anti-glutamatergic eff ects at NMDA receptors.…”

Section: Case Report ▼mentioning

confidence: 99%

Delusional Infestation Induced by Piribedil Add-On in Parkinson's Disease

Kölle¹,

Lepping²,

Kassubek³

et al. 2010

Pharmacopsychiatry

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“…2 Nadir olarak işitsel varsanılar ve kendine zarar verici davranışlar (tırnakların anormal kesilmesi, saçların ve vücut kıllarının kazınması ve vücuda pestisit uygulanması) gözlenir. 8 Kibrit kutusu belirtisinde hasta saç, deri, tırnak gibi çeşitli vücut parçalarını küçük bir kap, kutu, bez içinde doktora getirir. 2 Hastada var olan dermatolojik belirtiler doktora başvurma zamanına göre değişiklik gösterir.…”

Section: Discussionunclassified