Atypical antipsychotics in the treatment of delusional parasitosis

Delusional parasitosis is the false belief that one's body is infested with one or many different living organisms. Historically, it has been treated with conventional antipsychotics with only moderate success. The conventional antipsychotic most commonly used has been pimozide. We report a series of five cases of patients with delusional parasitosis. Our patients' demographic characteristics were similar to those in previously published case reports, but instead of being treated with older antipsychotics, they were all treated with atypical antipsychotic agents with favorable results. We will discuss the rationale for this treatment choice, and will review the role of serotonin/dopamine antagonists in the treatment of delusional parasitosis. We will also comment on the possible role of serotonergic antidepressants in the treatment of these patients.