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An update on psychopharmacological treatment of Body Dysmorphic Disorder (BDD)


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Abstract

Background: Body Dysmorphic Disorder (BDD) is a common, often severe disorder characterized by appearance concerns and a preoccupation with thinking and behaviors related to this concern. Population-based investigations have found a prevalence of BDD of 1.5-2% in the general population. The first-line of treatment for BDD is usually Selective Serotonin Reuptake Inhibitors (SSRI) which often alleviates suicidal thinking, and act to protect against further aggravation of suicidal thinking. For delusions, antipsychotic treatment is usually required. This review provides an update on guidelines and pharmacological treatment studies of BDD including recommendations for management and treatment.

Material and method: A narrative review of the current literature.

Results: A presentation of guidelines, some key studies and recommendations for pharmacological treatment of BDD.

Conclusion:Only one placebo controlled efficacy trial has been done finding that fluoxetin is superior to placebo in treatment of BDD. Several open trials support this finding and a randomized trial have found SSRI to reduce time to relapse. Clinical experiences suggest SSRI may reduce risk of suicidality. In severe cases, add-on treatment of second generation anti-psychotics may alleviate psychotic symptoms.

Keywords

body dysmorphic disorder, diagnosis, treatment, medicines, wrinkles, scars, thinning of hair, acne, vascular markings, pallor, ruddiness of skin texture, placebo

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