Table III.
Classes of medication reported to have an association with delusional infestation
| Drug | Neuropharmacological target | Cases, n | Case report (ref) |
|---|---|---|---|
| Parkinsonian drugs | |||
| Ropinirole | 1. D2, D3 and D4 receptor agonist | 6 | 10–12 |
| Amantadine | 1. Matrix protein 2 inhibitor (antiviral effect) | 5 | 12, 13, 15, 16 |
| 2. NMDA 3A receptor antagonist | |||
| 3. D2 receptor agonist | |||
| Piribedil | 1. D2 and D3 receptor agonist | 1 | 17 |
| 2. Alpha-2 adrenergic receptor antagonist | |||
| Cabergoline | 1. D2 receptor agonist | 1 | 11 |
| Levodopa/carbidopa | 1. Conversion to D | 1 | 16 |
| Pramipexole | 1. D2, D3 and D4 receptor agonist | 3 | 13–15 |
| Trihexyphenidyl | 1. Selective M1 muscarinic acetylcholine receptor antagonist | 1 | 12 |
| Entacapone | 1. Selective catechol-o-methyl transferase (COMT) inhibitor | 1 | 12 |
| 2. A increased effect of levodopa | |||
| Drug abuse | |||
| Amphetamine | 1. Blockade of DAT protein | 6 | 10, 27, 31 |
| 2. Blockade of NET protein | |||
| 3. 5-HT1A receptor antagonist | |||
| Cocaine | 1. Blockade of DAT protein | 6 | 32–35 |
| 2. 5-HT3 receptor antagonist | |||
| 3. 5-HT2A and 5-HT2C receptors agonist | |||
| 4. Inhibition of NET and SERT protein | |||
| Cannabis | 1. Stimulation of CB 1 and 2 receptor | 1 | 36 |
| Pemoline | 1. Inhibition of DAT protein | 1 | 37 |
| Antibiotics | |||
| Ciprofloxacin | 1. Blocks bacterial topoisomerase 2 and 4 (DNA gyrase) | 1 | 25 |
| 2. GABA-A receptor antagonist | |||
| Clarithromycin | 1. Blocks bacterial 50S ribosomal subunit | 1 | 26 |
| 2. GABA-A receptor antagonist | |||
| Antiviral drugs | |||
| Interferon alpha-2b | 1. IFNARI/2 receptor activation | 1 | 39 |
| Anti-epileptics | |||
| Topiramate | 1. GABA-A receptor agonist | 1 | 24 |
| 2. AMPA/kainate (glutamate) receptor antagonist | |||
| 3. Na+-channel blocker | |||
| Gabapentin | 1. GABA-A analogue | 1 | 23 |
| 2. Ca2+-channel blocker (P/Q type) | |||
| Antidepressants | |||
| Phenelzine | 1. MAO-A and B inhibitor | 2 | 18, 19 |
| 2. Inhibitor of ALT and GABA-T proteins | |||
| 3. Its metabolite, phenethylamine, has a releasing effect on NE and D | |||
| Doxepin | 1. Alpha-1 adrenergic receptor antagonist | 2 | 20, 21 |
| 2. Muscarinic cholinergic receptor antagonist | |||
| 3. H1 and H2 receptor antagonist | |||
| 4. Inhibition of NET and SERT protein | |||
| Sertraline | 1. Inhibition of SERT protein | 1 | 22 |
| Fluoxetine | 1. Inhibition of SERT, DAT and NET protein | 1 | 22 |
| 2. Antagonist 5-HT(2C) | |||
| Other drugs | |||
| Alprazolam | 1. GABA-A receptor agonist | 1 | 22 |
| Armodafinil | 1. Blockade of DAT protein | 1 | 10 |
| Atomoxetine | 1. Inhibition of NET protein | 1 | 38 |
| Cetirizine | 1. H1 receptor antagonist | 1 | 21 |
| Donepezil | 1. Inhibition of AChE | 1 | 40 |
ALT: alanine transaminase; D: dopamine; DAT: dopamine transporter, DI: delusional infestation; GABA: gamma-aminobutyric acid; H: histamine; 5-HT: serotonin; MAOI: monoamine oxidase inhibitor; NE: norepinephrine; NET: norepinephrine transporter; SERT: serotonin transporter; AChE: acetylcholinesterase; CB: cannabinoid; NMDA: N-methyl-D-aspartate; IFNAR: interferon-a/β receptor; AMPA: a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid.