La paranoïa : revue rapide sur la pharmacothérapie du trouble délirant

Abstract

ContextFor many clinicians, delusional disorder is associated with therapeutic pessimism. Psychological consequences of this disease, sometimes important for patients, family or other people, as well as the classical forensic reputation of dangerosity, indicate the needs for a best knowledge about the treatment of this disease. MethodsThis communication is a rapid review on the pharmacotherapy of delusional disorder. A literature search from inception to September 2021 was performed in PubMed, Scopus and Cochrane Database of Systematic Reviews, looking for systematic or narrative reviews of good quality. ResultsSystematic and narrative reviews emphasize the lack of randomised controlled trials or prospective studies and a low quality of evidence, limited to retrospective case series with an important risk of biases. In the state of our knowledge, these reviews suggest nonetheless the efficacy of antipsychotics and the interest of antidepressants, highlighting the importance of adhesion and compliance to treatment. Randomised controlled trials are recommanded and interesting pathways for research are proposed. ConclusionsEvidence-based proofs are seldom about effectiveness of pharmacotherapy in delusional disorder, so that there is a lack of recommendations or guidelines for the treatment in clinical practice. This disease is however described as responding to treatment in many situations, if the patient is compliant.