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Efavirenz induced delusional parasitosis

Author: 
Dr. Hari Babu Ramineni, Pravallika, E., Kumudini, V. and Dr. Vidhyadhara, S.
Subject Area: 
Health Sciences
Abstract: 

Delusional Parasitosis (DP) is characterized by the unshakeable conviction that small organisms infest the body despite the absence of confirmatory medical evidence. DP can occur in a wide variety of psychiatric disorders. Rarely DP can be drug-induced. A 35-year-old HIV positive woman with a history of epilepsy and tuberculosis is on ART regimen with first line ART combination Zidovudine, Lamivudine and Nevirapine but found to be ineffective and Nevirapine is replaced with Efavirenz. She developed pruritus and believes that beneath her skin parasites are present. Based on physical and psychiatric examination, she was diagnosed as Efavirenz induced delusional parasitosis. Consequently Efavirenz was stopped and she was treated with felt normal Risperidone 1 mg to control delusions. Efavirenz causes psychiatric symptoms as adverse effects, but this is, to our knowledge, the first reported case of Efavirenz induced Delusional parasitosis.

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