Benzodiazepine‐induced photosensitivity reactions: A compilation of cases from literature review with Naranjo causality assessment

Abstract

Objective: Benzodiazepines have been reported to cause photosensitivity reactions. We characterized the clinical presentation and diagnosis of benzodiazepineassociated photosensitivity and adjudicated these cases for a causal association with benzodiazepines.Methods: A literature search on PubMed's "MeSH" search feature and CINAHL (1964 to 2019) was performed using search terms: benzodiazepine, photosensitivity, and photosensitivity disorders/chemically induced. We applied the Naranjo scale, a standardized causality assessment algorithm, to identified cases. Results:We identified eight published cases, with 50% of patients being female with a mean age of 46.3 years. Alprazolam, tetrazepam, clobazam, and clorazepate induced phototoxic reactions. Chlordiazepoxide induced one photoallergic reaction.Photosensitivity occurred between 1-3 days (37.5%), 7-14 days (25%), and >14 days (25%). Photosensitivity resolved after drug discontinuation within 2 weeks (62.5%).Benzodiazepine rechallenge confirmed photosensitivity in 75% of cases. Photopatch testing was negative in two patients; however, these patients had positive oral provocation testing. However, an oral photoprovocation test, an ideal diagnostic test, was not administered to several patients. Despite these challenges, the Naranjo scale identified 5 cases as definite benzodiazepine-induced photosensitivity. Conclusion:Five benzodiazepines induced photosensitivity reactions. Five patients showed a definite association with the Naranjo scale. Reporting to pharmacovigilance databases may help identify other benzodiazepines causing photosensitivity reactions.

Longitudinal cytokine and multi-modal health data of an extremely severe ME/CFS patient with HSD reveals insights into immunopathology, and disease severity

“…Abilify’s acts on dopamine D2 and serotonin 5-HT1A receptors, as a partial agonist and antagonist, respectively ( 263 ). As a partial agonist, Abilify could act as a D2 agonist, increasing dopamine activity in the presence of low levels of endogenous dopamine and exerting antagonistic activity in the presence of high levels ( 263 ).…”

“…Abilify’s acts on dopamine D2 and serotonin 5-HT1A receptors, as a partial agonist and antagonist, respectively ( 263 ). As a partial agonist, Abilify could act as a D2 agonist, increasing dopamine activity in the presence of low levels of endogenous dopamine and exerting antagonistic activity in the presence of high levels ( 263 ). An in-depth investigation into aberrant dopaminergic signaling in ME/CFS and Abilify’s use is warranted, given varying anecdotal reports, some indicating benefits and others worsening symptoms ( 264 ).…”