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Efficacy of antipsychotics in delusional infestation.
Tang, Paul K; Lepping, Peter; Lepping, Sophie G; Noorthoorn, Eric O; Squire, Stephen B; Mohandas, Padma; Bewley, Anthony.
Afiliação
  • Tang PK; Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK.
  • Lepping P; Heddfan Psychiatric Unit, Wrexham Maelor Hospital Psychiatric Liaison Team, Wrexham, UK.
  • Lepping SG; Centre for Mental Health and Society, Bangor University, Bangor, UK.
  • Noorthoorn EO; Mysore Medical College and Research Institute, Mysuru, India.
  • Squire SB; School of Medicine, Cardiff University, Cardiff, UK.
  • Mohandas P; Ggnet Mental Health Trust, Warnsveld, The Netherlands.
  • Bewley A; Radboud University Nijmegen, Nijmegen, Netherlands.
Article em En | MEDLINE | ID: mdl-38727630
ABSTRACT

BACKGROUND:

Data remain scarce for the first-line antipsychotic choice in treating delusional infestation (DI).

OBJECTIVES:

We evaluated the treatment responses associated with different antipsychotics in DI patients.

METHODS:

We undertook a multicentre, retrospective observational study using anonymised electronic patient records from two hospitals in the United Kingdom from 1 January 2011 to 1 January 2023. Eligible participants were adults (≥18 years) diagnosed with DI treated with an antipsychotic, and had both an assigned baseline and follow-up Clinical Global Impression Scale (CGI-S) score. The CGI-S is a validated psychiatric research tool. Participants were excluded if they had known limited or non-adherence to an antipsychotic, or if no CGI-S scores were present at follow-up. First clinic visits before the initiation of an antipsychotic were assigned as the baseline CGI-S score. The last available CGI-S score before the patient either changed antipsychotic or left the clinic for any reason was used to assign follow-up CGI-S scores. The primary outcome was the response to each individual antipsychotic treatment, measured by the difference in the baseline and last available follow-up CGI-S scores. Differences in CGI-S changes between antipsychotic episodes were tested by analysis of variance (ANOVA).

RESULTS:

In total, 414 patient records were analysed, and data were extracted. The mean age was 61.8 years (SD 14.1). One hundred seventy (41%) of 414 patients were men and 244 (59%) were women. In total, 156 (38%) of 414 patients were eligible, yielding a total of 315 antipsychotic prescribing episodes. The ANOVA, ranking in order of treatment response, showed that the highest mean score (expressing highest treatment response) was observed in amisulpride (31 [67%] of 46) and risperidone (95 [57%] of 167), followed by some distance by quetiapine (9 [36%] of 25), aripiprazole (13 [28%] of 46) and olanzapine (7 [25%] of 28).

CONCLUSIONS:

Amisulpride and risperidone were associated with a higher treatment response than quetiapine, aripiprazole and olanzapine. Amisulpride and risperidone should therefore be considered the first-line treatment options in DI patients.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Eur Acad Dermatol Venereol Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Eur Acad Dermatol Venereol Ano de publicação: 2024 Tipo de documento: Article