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Yıl:2012; Cilt: 13; Sayı: 3>> Özet
Anadolu Psikiyatri Dergisi; 2012;13(3):239-242
Sanrısal parazitozun tedavi seçenekleri: On dört hastalık olgu serisi
B Coşar, K Taşkınoğlu, P Lepping, S Burhanoğlu, HY Eser, ME Taner, Z Arıkan
Gazi Üniversitesi, Ankara
Sanrısal parazitoz (SP) hastaların parazitlerle enfekte oldukları sanrısal inancını geliştirdikleri nadir görülen bir psikiyatrik bozuk-luktur. Tedavisi için ikinci kuşak antipsikotikler ve antidepresanlar kullanılabilir. Geleneksel olarak birinci kuşak antipsikotiklerden olan pimozid kullanılmıştır. SP tanısı konan olgu serisinde pimozide göre ikinci kuşak antipsikotik ilaçların etkinliğini araştırmak ve SP'nin kültürler arasında geçerliliğini değerlendirmektir. Yöntem: Birincil veya ikincil SP tanısı konan 14 hastanın demografik ve klinik değiş-kenlerinin yanı sıra, klorpromazin eşdeğeri dozlarda tedaviye verdikleri yanıtlar değerlendirilmiştir. On dört hasta altı ay izlenmiştir. Sonuçlar: Pimozid alan tüm hastalar tam remisyona girmiştir. Olanzapin alanlarda remisyon oranı %71, risperidon alanlarda %50 olarak bulunmuştur. Tam remisyon elde etmek için kullanılan klorpromazin eşdeğeri dozlarda en düşük doz olanzapinde, ardından risperidon ve pimozidde kullanılmıştır. SP Türkiye bağlamında geçerli bir tanı olarak bulunmuştur. Tartışma: Klinik ve demografik veriler SP'nin farklı kültürler arasında tutarlı bir tanı kategorisi olduğunu göstermektedir. İyi bir uyum sağlandığında, hem birinci, hem de ikinci kuşak antipsikotiklerle iyi remisyon oranları elde edilebilir.
Treatment options of delusional parasitosis: case series of 14 patients
Objective: Delusional parasitosis (DP) is a rare psychiatric disorder in which patients develop the delusional belief that they are in-fested by parasites. Second generation antipsychotics and antidepressants can be used for its treatment. Traditionally the first gener-ation antipsychotic pimozide has been used. The aim of this article is to investigate the efficacy of second generation antipsychotics compared to pimozide in a case series of patients with DP and to evaluate the validity of DP across cultures. Methods: We have evaluated fourteen patients with primary or secondary DP regarding their demographic and clinical variables as well as their re-sponses to treatment including chlorpromazine equivalent doses. We saw fourteen patients for a six [month] follow up period. Re-sults: Complete remission was achieved in all patients on pimozide therapy. The remission rates for those on olanzapine were 71%, for those on risperidone were 50%. The lowest doses in chlorpromazine equivalent doses to achieve full remission were used with olanzapine, followed by risperidone and pimozide. DP was found to be a valid diagnosis in the Turkish context. Discussion: Clinical and demographic data suggests that DP is a stable diagnostic category across different cultures. Good remission rates can be achieved with first and second generation antipsychotics when compliance can be established.

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