Nature and treatment of delusional parasitosis: a different experience in India.

BACKGROUND: Delusional parasitosis has been described as a rare syndrome, often involving elderly women who respond poorly to treatment except to pimozide.

METHOD: Nineteen cases of delusional parasitosis given antipsychotic treatment other than pimozide were followed up and the responses assessed in a structured manner.

RESULTS: The frequency of the syndrome was higher than generally reported and the patients were younger and had been ill for a shorter period. There was good response to antipsychotic treatments using trifluoperazine, haloperidol, chlorpromazine, and electroconvulsive therapy, and 11 cases showed complete remission, five of them maintaining the recovery for more than 3 years.

CONCLUSIONS: Delusional parasitosis is not as rare as described: it does not need to be chronic, and can involve young patients. Antipsychotic treatments other than pimozide are equally effective in delusional parasitosis especially if the patients are young and seen early in the illness. The frequency and nature of the disorder observed could probably be due to regional cultural factors.