Drug-induced Delusional Infestation
DOI:
https://doi.org/10.2340/actadv.v102.183Keywords:
delusional infestation, drug-induced, secondary delusional infestation, psychodermatologyAbstract
It is considered that certain drugs might induce delusional infestation, yet, to date, no studies have been performed to identify the pharmacodynamics associated with these treatments. The aim of this review is to summarize current available knowledge of drug-induced delusional infestation. A literature search was performed for primary studies on suspected drugs reported to induce delusional infestation. Included articles were evaluated systematically using the Naranjo criteria. In addition, drug mechanisms of action were compared. The final selection included 31 studies, in which a total of 26 classes of drugs were identified. Anti-Parkinson drugs were most frequently associated with delusional infestation, followed by antidepressants, antiepileptics, antibiotics, prescription stimulants, and a few other drug groups. The current available literature suggests that the onset of delusional infestation is initiated by drug-induced alterations in neurotransmitter levels, predominantly dopamine, in the central nervous system.
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References
Hughes JE, Barraclough BM, Hamblin LG, White JE. Psychiatric symptoms in dermatology patients. Br J Psychiatry 1983; 143: 51-54.
https://doi.org/10.1192/bjp.143.1.51 DOI: https://doi.org/10.1192/bjp.143.1.51
Freudenmann RW, Lepping P. Delusional infestation. Clin Microbiol Rev 2009; 22: 690-732.
https://doi.org/10.1128/CMR.00018-09 DOI: https://doi.org/10.1128/CMR.00018-09
Kohorst JJ, Bailey CH, Andersen LK, Pittelkow MR, Davis MDP. Prevalence of delusional infestation - a population-based study. JAMA Dermatol 2018; 154: 615-617.
https://doi.org/10.1001/jamadermatol.2018.0004 DOI: https://doi.org/10.1001/jamadermatol.2018.0004
Bewley AP, Lepping P, Freudenmann RW, Taylor R. Delusional parasitosis: time to call it delusional infestation. Br J Dermatol 2010; 163:1-2. Erratum in: Br J Dermatol 2010; 163: 899.
https://doi.org/10.1111/j.1365-2133.2010.09841.x DOI: https://doi.org/10.1111/j.1365-2133.2010.09841.x
Vulink NC. Delusional infestation: state of the art. Acta Derm Venereol 2016; 96: 58-63.
Lepping P, Aboalkaz S, Squire SB, Romanov DV, Bewley A, Huber M, et al. Later age of onset and longer duration of untreated psychosis are associated with poorer outcome in delusional infestation. Acta Derm Venereol 2020; 100: adv00261.
https://doi.org/10.2340/00015555-3625 DOI: https://doi.org/10.2340/00015555-3625
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.
https://doi.org/10.1176/appi.books.9780890425596 DOI: https://doi.org/10.1176/appi.books.9780890425596
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.
Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239-245.
https://doi.org/10.1038/clpt.1981.154 DOI: https://doi.org/10.1038/clpt.1981.154
Fowler E, Maderal A, Yosipovitch G. Treatment-induced delusions ofinfestation associated with increased brain dopamine levels. Acta Derm Venereol 2019; 99: 327-328.
https://doi.org/10.2340/00015555-3093 DOI: https://doi.org/10.2340/00015555-3093
Flann S, Shotbolt J, Kessel B, Vekaria D, Taylor R, Bewley A, et al. Three cases of delusional parasitosis caused by dopamine agonists. Clin Exp Dermatol 2010; 35: 740-742.
https://doi.org/10.1111/j.1365-2230.2010.03810.x DOI: https://doi.org/10.1111/j.1365-2230.2010.03810.x
Davis JL, Kurek JA, Sethi KD, Morgan JC. Delusional infestation in Parkinson's disease. Mov Disord Clin Pract 2016; 4: 111-115.
https://doi.org/10.1002/mdc3.12352 DOI: https://doi.org/10.1002/mdc3.12352
Moro A, Munhoz RP, Moscovich M, Arruda WO, Teive HA. Delusional misidentification syndrome and other unusual delusions in advanced Parkinson's disease. Parkinsonism Relat Disord 2013; 19: 751-754.
https://doi.org/10.1016/j.parkreldis.2013.04.021 DOI: https://doi.org/10.1016/j.parkreldis.2013.04.021
Romero Sandoval K, Festa Neto C, Nico MMS. Delusional infestation caused by pramipexole. Clin Exp Dermatol 2018; 43: 192-193.
https://doi.org/10.1111/ced.13292 DOI: https://doi.org/10.1111/ced.13292
Ojeda-López C, Aguilar-Venegas LC, Tapia-Orozco M, Cervantes-Arriaga A, Rodríguez-Violante M. Delusional parasitosis as a treatment complication of Parkinson disease. Psychosomatics 2015; 56: 696-699.
https://doi.org/10.1016/j.psym.2015.07.004 DOI: https://doi.org/10.1016/j.psym.2015.07.004
Swick BL, Walling HW. Drug-induced delusions of parasitosis during treatment of Parkinson's disease. J Am Acad Dermatol 2005; 53: 1086-1087.
https://doi.org/10.1016/j.jaad.2005.06.040 DOI: https://doi.org/10.1016/j.jaad.2005.06.040
Kölle M, Lepping P, Kassubek J, Schönfeldt-Lecuona C, Freudenmann RW. Delusional infestation induced by piribedil add-on in Parkinson's disease. Pharmacopsychiatry 2010; 43: 240-242.
https://doi.org/10.1055/s-0030-1261881 DOI: https://doi.org/10.1055/s-0030-1261881
Liebowitz MR, Nuetzel EJ, Bowser AE, Klein DF. Phenelzine and delusions of parasitosis: a case report. Am J Psychiatry 1978; 135: 1565-1566.
https://doi.org/10.1176/ajp.135.12.1565 DOI: https://doi.org/10.1176/ajp.135.12.1565
Aizenberg D, Schwartz B, Zemishlany Z. Delusional parasitosis associated with phenelzine. Br J Psychiatry 1991; 159: 716-717.
https://doi.org/10.1192/bjp.159.5.716 DOI: https://doi.org/10.1192/bjp.159.5.716
Damiani JT, Flowers FP, Pierce DK. Pimozide in delusions of parasitosis. J Am Acad Dermatol 1990; 22: 312-313.
https://doi.org/10.1016/S0190-9622(08)80767-0 DOI: https://doi.org/10.1016/S0190-9622(08)80767-0
Reichenberg JS, Magid M, Drage LA. A cure for delusions of parasitosis. J Eur Acad Dermatol Venereol 2007; 21: 1423-1424.
https://doi.org/10.1111/j.1468-3083.2007.02229.x DOI: https://doi.org/10.1111/j.1468-3083.2007.02229.x
Wenning MT, Davy LE, Catalano G, Catalano MC. Atypical antipsychotics in the treatment of delusional parasitosis. Ann Clin Psychiatry 2003; 15: 233-239. DOI: https://doi.org/10.3109/10401230309085693
https://doi.org/10.1023/B:ACLI.0000008687.21295.8a DOI: https://doi.org/10.1023/B:ACLI.0000008687.21295.8a
Lopez PR, Rachael T, Leicht S, Smalligan RD. Gabapentin-induced delusions of parasitosis. South Med J 2010; 103: 711-712.
https://doi.org/10.1097/SMJ.0b013e3181e1e449 DOI: https://doi.org/10.1097/SMJ.0b013e3181e1e449
Fleury V, Wayte J, Kiley M. Topiramate-induced delusional parasitosis. J Clin Neurosci 2008; 15: 597-599.
https://doi.org/10.1016/j.jocn.2006.12.017 DOI: https://doi.org/10.1016/j.jocn.2006.12.017
Steinert T, Studemund H. Acute delusional parasitosis under treatment with ciprofloxacin. Pharmacopsychiatry 2006; 39: 159-160.
https://doi.org/10.1055/s-2006-947183 DOI: https://doi.org/10.1055/s-2006-947183
Tse KC, Li FK, Tang S, Lam MF, Chan TM, Lai KN. Delusion of worm infestation associated with clarithromycin in a patient on peritoneal dialysis. Perit Dial Int 2001; 21: 415-416.
https://doi.org/10.1177/089686080102100416 DOI: https://doi.org/10.1177/089686080102100416
Buscarino M, Saal J, Young JL. Delusional parasitosis in a female treated with mixed amphetamine salts: a case report and literature review. Case Rep Psychiatry 2012; 2012: 624235.
https://doi.org/10.1155/2012/624235 DOI: https://doi.org/10.1155/2012/624235
Yeh TC, Lin YC, Chen LF, Chiang CP, Mao WC, Chang HA, et al. Aripiprazole treatment in a case of amphetamine-induced delusional infestation. Aust N Z J Psychiatry 2014; 48: 681-682.
https://doi.org/10.1177/0004867414525849 DOI: https://doi.org/10.1177/0004867414525849
Stanciu CN, Penders TM, Oxentine HN. Delusional infestation following misuse of prescription stimulants. Psychosomatics 2015; 56: 210-212.
https://doi.org/10.1016/j.psym.2014.03.004 DOI: https://doi.org/10.1016/j.psym.2014.03.004
Beach SR, Kroshinsky D, Kontos N. Case records of the Massachusetts General Hospital. Case 37-2014. A 35-year-old woman with suspected mite infestation. N Engl J Med 2014; 371: 2115-2123.
https://doi.org/10.1056/NEJMcpc1305989 DOI: https://doi.org/10.1056/NEJMcpc1305989
Marschall MA, Dolezal RF, Cohen M, Marschall SF. Chronic wounds and delusions of parasitosis in the drug abuser. Plast Reconstr Surg 1991; 88: 328-230.
https://doi.org/10.1097/00006534-199108000-00027 DOI: https://doi.org/10.1097/00006534-199108000-00027
Elliott A, Mahmood T, Smalligan RD. Cocaine bugs: a case report of cocaine-induced delusions of parasitosis. Am J Addict 2012; 21: 180-181.
https://doi.org/10.1111/j.1521-0391.2011.00208.x DOI: https://doi.org/10.1111/j.1521-0391.2011.00208.x
Jagt YQ, Sutterland AL, Meijer JH, Oudijn MS, Kemperman PM, Vulink NC, et al. Delusional infestation, a therapeutic challenge. Ned Tijdschr Geneeskd 2014; 158: A7548.
Ahmad K, Ramsay B. Delusional parasitosis: lessons learnt. Acta Derm Venereol 2009; 89: 165-168.
https://doi.org/10.2340/00015555-0587 DOI: https://doi.org/10.2340/00015555-0587
Brewer JD, Meves A, Bostwick JM, Hamacher KL, Pittelkow MR. Cocaine abuse: dermatologic manifestations and therapeutic approaches. J Am Acad Dermatol 2008; 59: 483-487.
https://doi.org/10.1016/j.jaad.2008.03.040 DOI: https://doi.org/10.1016/j.jaad.2008.03.040
Freudenmann RW, Kölle M, Huwe A, Luster M, Reske SN, Huber M, et al. Delusional infestation: neural correlates and antipsychotic therapy investigated by multimodal neuroimaging. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34: 1215-1222. Erratum in: Prog Neuropsychopharmacol Biol Psychiatry 2012; 36: 324.
https://doi.org/10.1016/j.pnpbp.2011.11.013 DOI: https://doi.org/10.1016/j.pnpbp.2011.11.013
Krauseneck T, Soyka M. Delusional parasitosis associated with pemoline. Psychopathology 2005; 38: 103-104.
https://doi.org/10.1159/000085352 DOI: https://doi.org/10.1159/000085352
Howes CF, Sharp C. Delusional infestation in the treatment of ADHD with atomoxetine. BMJ Case Rep 2018; bcr2018226020.
https://doi.org/10.1136/bcr-2018-226020 DOI: https://doi.org/10.1136/bcr-2018-226020
Robaeys G, De Bie J, Van Ranst M, Buntinx F. An extremely rare case of delusional parasitosis in a chronic hepatitis C patient during pegylated interferon alpha-2b and ribavirin treatment. World J Gastroenterol 2007; 13: 2379-2380.
https://doi.org/10.3748/wjg.v13.i16.2379 DOI: https://doi.org/10.3748/wjg.v13.i16.2379
Rosenzweig I, Ramachandra P, Freer J, Wong M, Pieters T. Delusional parasitosis associated with donepezil. J Clin Psychopharmacol 2011; 31: 781-782.
https://doi.org/10.1097/JCP.0b013e3182358387 DOI: https://doi.org/10.1097/JCP.0b013e3182358387
Huber M, Kirchler E, Karner M, Pycha R. Delusional parasitosis and the dopamine transporter. A new insight of etiology? Med Hypotheses 2007; 68: 1351-1358.
https://doi.org/10.1016/j.mehy.2006.07.061 DOI: https://doi.org/10.1016/j.mehy.2006.07.061
Huber MK, Schwitzer J, Kirchler E, Lepping P. Delusion and dopamine: neuronal insights in psychotropic drug therapy. NeuroPsychopharmacotherapy Springer, Cham, 2021.
https://doi.org/10.1007/978-3-319-56015-1_411-1 DOI: https://doi.org/10.1007/978-3-319-56015-1_411-1
Tost H, Alam T, Meyer-Lindenberg A. Dopamine and psychosis: theory, pathomechanisms and intermediate phenotypes. Neurosci Biobehav Rev 2010; 34: 689-700.
https://doi.org/10.1016/j.neubiorev.2009.06.005 DOI: https://doi.org/10.1016/j.neubiorev.2009.06.005
Kesby JP, Eyles DW, McGrath JJ, Scott JG. Dopamine, psychosis and schizophrenia: the widening gap between basic and clinical neuroscience. Transl Psychiatry 2018; 8: 30.
https://doi.org/10.1038/s41398-017-0071-9 DOI: https://doi.org/10.1038/s41398-017-0071-9
Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med 1999; 130: 910-921.
https://doi.org/10.7326/0003-4819-130-11-199906010-00016 DOI: https://doi.org/10.7326/0003-4819-130-11-199906010-00016
Joyce EM. Organic psychosis: the pathobiology and treatment of delusions. CNS Neurosci Ther 2018; 24: 598-603.
https://doi.org/10.1111/cns.12973 DOI: https://doi.org/10.1111/cns.12973
Stahl SM. Beyond the dopamine hypothesis of schizophrenia to three neural networks of psychosis: dopamine, serotonin, and glutamate. CNS Spectr 2018; 23: 187-191.
https://doi.org/10.1017/S1092852918001013 DOI: https://doi.org/10.1017/S1092852918001013
Bleich A, Brown SL, Kahn R, van Praag HM. The role of serotonin in schizophrenia. Schizophren Bull 1988; 14: 297-315.
https://doi.org/10.1093/schbul/14.2.297 DOI: https://doi.org/10.1093/schbul/14.2.297
Bramness JG, Rognli EB. Psychosis induced by amphetamines. Curr Opin Psychiatry 2016; 29: 236-241.
https://doi.org/10.1097/YCO.0000000000000254 DOI: https://doi.org/10.1097/YCO.0000000000000254
Lepping P, Noorthoorn EO, Kemperman PMJH, Harth W, Reichenberg JS, Squire SB, et al. An international study of the prevalence of substance use in patients with delusional infestation. J Am Acad Dermatol 2017; 77: 778-779.
https://doi.org/10.1016/j.jaad.2017.06.024 DOI: https://doi.org/10.1016/j.jaad.2017.06.024
Mowla A, Asadipooya K. Delusional parasitosis following heroin withdrawal: a case report. Am J Addict 2009; 18: 334-345.
https://doi.org/10.1080/10550490902925888 DOI: https://doi.org/10.1080/10550490902925888
Reich A, Kwiatkowska D, Pacan P. Delusions of parasitosis: an update. Dermatol Ther (Heidelb) 2019; 9: 631-638.
https://doi.org/10.1007/s13555-019-00324-3 DOI: https://doi.org/10.1007/s13555-019-00324-3
Marshall CL, Ellis C, Williams V, Taylor RE, Bewley AP. Iatrogenic delusional infestation: an observational study. Br J Dermatol 2016; 175: 800-802.
https://doi.org/10.1111/bjd.14558 DOI: https://doi.org/10.1111/bjd.14558
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