Aripiprazole and fluoxetine in the treatment of delusional parasitosis: a case report

Abstract

Delusional parasitosis is a rare psychiatric symptom that presents with the delusion of being invested with bugs, microorganisms or harmful parasites without any accompanying medical or psychiatric disorders. Delusional parasitosis is included in the “delusional disorder, somatic subtype” in the DSM-5. It is two-fold more frequent in females. High frequency is also related with being married, low education status and low socioeconomical status. Late diagnosis leads to chronical delusions. Typical and atypical antipsychotic drugs are used for treatment. In cases with concurrent depression, use of serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors might be useful. As far as we know, no cases treated with antidepressant and antipsychotic drug combination were reported, in the literature. We report a delusional parasitosis case with acute onset and treated with aripiprazole (5 mg/day) and fluoxetine (40 mg/day). Full remission was achieved in two months.