The case of a 40-year-old man with delusions of parasitosis as the pre
sentation of a monodelusional psychosis is reported. In spite of treat
ment with pimozide and depot neuroleptics the patient committed suicid
e. Since the introduction of pimozide, this drug has come to be regard
ed as the specific treatment for this disorder; this case is presented
to emphasize the fact that not all cases respond, and that the disord
er can have a fatal outcome.