Delusions and Dermatologists: Long-Term Treatment Needed for Delusional Parasitosis

Patients with delusional infestation (DI) maintain a false and fixed belief of infestation. No amount of reason will convince them that the organisms they experience are imagined. Dermatologists usually have to initiate treatment with psychiatric drugs, since patients often balk at referral to psychiatrists. Is it really worth the effort to convince a patient to take psychiatric medications?

Working in a combined dermatology/psychiatry clinic, physicians recommended pharmacologic treatment to 73 patients with DI. Only 59 accepted. Most patients received risperidone, olanzapine, or amisulpride. Others received other antidepressant drugs, such as citalopram, fluoxetine, and doxepin. Later, all treated patients were contacted by phone. About on…