What is your approach in counseling a patient with delusions of parasitosis?  

Delusions of parasitosis (DOP) or delusions of infestation (DOI) are among the most challenging conditions we treat as dermatologists. I am not sure there is one approach to treating these patients and it can often feel very frustrating and unsatisfying. Nonetheless, we all will encounter these pati...

These are my favorite patients to take care of and are some of the easiest patients to take care of in dermatology. This only applies to patients with isolated "delusions of parasitosis" not to patients with DOP as a manifestation of complex underlying psychopathology. And incidentally, I don't call...

After ruling out other diagnostic possibilities, and addressing any underlying conditions, I counsel patients with delusions of parasitosis by first validating their experience of distressing symptoms and explaining that since the workup was unrevealing (if this is the case), we can treat with a med...

Pimozide to date is the most effective therapeutic modality; the challenge is convincing affected patients to take it.

Risperdal. Pimozide is the textbook answer but there’s evidence it’s just old-school thinking.Risperidone has been extensively studied and shown to be effective in treating DP. A retrospective study of 27 patients treated with risperidone demonstrated significant symptom control in ...

I agree with the idea of Pimozide, as it has been shown to be helpful with mono-symptomatic delusions, like Parasitosis. I have found it efficacious for Capgras Syndrome and wrote an article about it some 30 years ago. I successfully treated one other patient with Capgras since the article. Pimozide...

As a child psychiatrist, I saw a few patients with this presentation. Most had family histories of various anxiety disorders, but the child's level of distress and effect on daily function became significant.  I would use a similar discussion on the cause of the symptoms with the child as Dr. ...