October 22, 1997

Treatment of Delusional Parasitoses-Reply

Author Affiliations

University of California, San Francisco

JAMA. 1997;278(16):1320. doi:10.1001/jama.1997.03550160040034

In Reply.  —The suggestion by Dr Clayton and others regarding the use of EPS-sparing antipsychotic drugs for the treatment of delusions of parasitosis is a good idea that needs to be evaluated clinically. If these medications do work well for delusions of parasitosis, they can certainly replace pimozide as the treatment of choice. However, these EPS-sparing antipsychotic medications may not work as well as pimozide. This possibility arises because there is something unique about pimozide compared with the other antipsychotic agents, and this uniqueness may be responsible for pimozide's particular efficacy for this condition: pimozide has great efficacy for formication (crawling, biting, and stinging sensations).1 In Europe, it was found that there are only 2 antipsychotic medications that have profound effect on formication: one is pimozide and the other is flusipilene, a long-acting antipsychotic medication not available in the United States.2 Both of these medications are unique in that they