Treatment of Ekbom Syndrome With Clozapine and Electroconvulsive Therapy

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Abstract

Delusion of parasitosis (DP), which is also known as Ekbom syndrome, is a delusional disorder characterised by a false, fixed belief of being infested by insects or mites, despite the lack of supporting medical evidence. This disorder presents most commonly with the “Matchbox sign.” DP can present as a primary or secondary delusional disorder. It can be associated with various psychiatric conditions such as schizophrenia spectrum disorders, mood disorders, anxiety or substance abuse. Several organic conditions such as dementia, malignancies, vitamin deficiencies and cerebrovascular accidents can mimic symptoms of DP. Hereby, we present a case of schizophrenia in a young woman associated with DP in our inpatient care and the treatment outcome with the use of clozapine and electroconvulsive therapy (ECT) regimen.

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Most cited references 11

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Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia: a prospective, randomized study.

Georgios Petrides, Chitra Malur, Raphael Braga … (2015)

Up to 70% of patients with treatment-resistant schizophrenia do not respond to clozapine. Pharmacological augmentation to clozapine has been studied with unimpressive results. The authors examined the use of ECT as an augmentation to clozapine for treatment-refractory schizophrenia.

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Diagnosis and Management of Delusional Parasitosis

Elliott H. Campbell, Dirk M. Elston, James Hawthorne … (2018)

Delusional parasitosis is a monosymptomatic hypochondriacal state that causes great suffering for the patient and great suffering for those around them. Dermatologists are experts in the diagnosis of cutaneous disease and frequently encounter such patients. This review provides an overview of the diagnosis and management of delusional parasitosis and the differential diagnosis.

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Delusions of Parasitosis: An Update

Adam Reich, Dominika Kwiatkowska, Przemyslaw Pacan (2019)

Delusional parasitosis, also known as delusional infestation or Ekbom syndrome, is a relatively infrequent psychotic disorder characterized by an unwavering false belief that there is a parasitic infestation of the skin, despite the absence of any medical evidence that could support this claim. Delusional parasitosis can be categorized into primary, secondary, and organic forms. Sometimes, close relatives also experience identical delusions. This phenomenon was reported to occur in 5–15% of cases, and is known as shared psychotic disorder–delusional parasitosis with folie à deux. Patients with delusional parasitosis frequently seek help from many physicians. Close multidisciplinary cooperation between clinicians is often key to shortening the time taken to diagnose this disorder. Initiation of psychopharmacological therapy is a challenge, as many patients refuse any psychiatric treatment because of the stigma associated with mental illness and because of their firm belief that they have a parasitic infestation, not a psychiatric condition. For many patients, a sense of a lack of understanding leads to isolation and the development of depression symptoms, which is why it is crucial to earn the trust of such patients while taking care of them.

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Author and article information

Journal

Journal ID (nlm-ta): Cureus

Journal ID (iso-abbrev): Cureus

Journal ID (issn): 2168-8184

Title: Cureus

Publisher: Cureus (Palo Alto (CA) )

ISSN (Electronic): 2168-8184

Publication date (Electronic, pub): 19 October 2022

Publication date (Electronic, collection): October 2022

Volume: 14

Issue: 10

Electronic Location Identifier: e30469

Affiliations

[1 ] Department of Psychiatry, Bhartiya Arogya Nidhi Hospital, Mumbai, IND

Author notes

Aakanksha Singh singh.aakanksha93@ 123456gmail.com

Article

DOI: 10.7759/cureus.30469

PMC ID: 9673619

PubMed ID: 36415401

SO-VID: ddec0d9c-c550-49a4-a364-6f0752a80f23

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date accepted : 15 October 2022

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