Chlorpromazine-induced severe exfoliative photoallergic reaction

Dhanasekaran, Saranya; Kar, Sujita Kumar; Yadav, Suresh

doi:10.4103/2231-0738.150074

Cited by 3 publications

(2 citation statements)

References 9 publications

(14 reference statements)

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“…Phototoxicity manifests variably, and in addition to classic exaggerated sunburn-like eruptions, may show features of actinic reticuloid, eczematous dermatitis, exfoliative, bullous, or lichenoid eruptions [ 29 , 118 , 119 ]. Moreover, a common photoreaction to CPZ is the greying of sun-exposed skin.…”

Section: Phototoxic Drugsmentioning

confidence: 99%

“…Particularly, electron microscopy of a skin biopsy showed dense inclusion bodies within cells and the extracellular matrix, while microprobe analysis indicated a prominent sulfur peak, strongly indicating the presence of CPZ or its metabolite [ 120 ]. Previous studies have reported chlorpromazine phototoxicity with 400–600 mg/day [ 118 , 166 ].…”

Section: Phototoxic Drugsmentioning

confidence: 99%

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The phenomenon of phototoxicity and long-term risks of commonly prescribed and structurally diverse drugs

Davis,

Kennelley,

Amaye-Obu

et al. 2024

Journal of Photochemistry and Photobiology

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Section: Phototoxic Drugsmentioning

confidence: 99%

Section: Phototoxic Drugsmentioning

confidence: 99%

The phenomenon of phototoxicity and long-term risks of commonly prescribed and structurally diverse drugs

Davis,

Kennelley,

Amaye-Obu

et al. 2024

Journal of Photochemistry and Photobiology

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Antipsychotic-Related DRESS Syndrome: Analysis of Individual Case Safety Reports of the WHO Pharmacovigilance Database

de Filippis,

Kane,

Arzenton

et al. 2024

Drug Saf

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Introduction Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is gaining attention in pharmacovigilance, but its association with antipsychotics, other than clozapine, is still unclear. Methods We conducted a case/non-case study with disproportionality analysis based on the World Health Organization (WHO) global spontaneous reporting database, VigiBase®. We analyzed individual case safety reports of DRESS syndrome related to antipsychotics compared to (1) all other medications in VigiBase®, (2) carbamazepine (a known positive control), and (3) within classes (typical/atypical) of antipsychotics. We calculated reporting odds ratio (ROR) and Bayesian information component (IC), with 95% confidence intervals (CIs). Disproportionate reporting was prioritized based on clinical importance, according to predefined criteria. Additionally, we compared characteristics of patients reporting with serious/non-serious reactions. Results A total of 1534 reports describing DRESS syndrome for 19 antipsychotics were identified. The ROR for antipsychotics as a class as compared to all other medications was 1.0 (95% CI 0.9–1.1). We found disproportionate reporting for clozapine (ROR 2.3, 95% CI 2.1–2.5; IC 1.2, 95% CI 1.1–1.3), cyamemazine (ROR 2.3, 95% CI 1.5–3.5; IC 1.2, 95% CI 0.5–1.7), and chlorpromazine (ROR 1.5, 95% CI 1.1–2.1; IC 0.6, 95% CI 0.1–1.0). We found 35.7% of cases with co-reported anticonvulsants, and 25% with multiple concurrent antipsychotics in serious compared to 8.6% in non-serious cases ( p = 0.03). Fatal cases were 164 (10.7%). Conclusions Apart from the expected association with clozapine, chlorpromazine and cyamemazine (sharing an aromatic heteropolycyclic molecular structure) emerged with a higher-than-expected reporting of DRESS. Better knowledge of the antipsychotic-related DRESS syndrome should increase clinicians’ awareness leading to safer prescribing of antipsychotics. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-024-01431-7.

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A Double-Edged Sword: Thioxanthenes Act on Both the Mind and the Microbiome

Poulsen

Dastidar²,

Roy³

et al. 2021

Molecules

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The rising tide of antibacterial drug resistance has given rise to the virtual elimination of numerous erstwhile antibiotics, intensifying the urgent demand for novel agents. A number of drugs have been found to possess potent antimicrobial action during the past several years and have the potential to supplement or even replace the antibiotics. Many of these ‘non-antibiotics’, as they are referred to, belong to the widely used class of neuroleptics, the phenothiazines. Another chemically and pharmacologically related class is the thioxanthenes, differing in that the aromatic N of the central phenothiazine ring has been replaced by a C atom. Such “carbon-analogues” were primarily synthesized with the hope that these would be devoid of some of the toxic effects of phenothiazines. Intensive studies on syntheses, as well as chemical and pharmacological properties of thioxanthenes, were initiated in the late 1950s. Although a rather close parallelism with respect to structure activity relationships could be observed between phenothiazines and thioxanthenes; several thioxanthenes were synthesized in pharmaceutical industries and applied for human use as neuroleptics. Antibacterial activities of thioxanthenes came to be recognized in the early 1980s in Europe. During the following years, many of these drugs were found not only to be antibacterial agents but also to possess anti-mycobacterial, antiviral (including anti-HIV and anti-SARS-CoV-2) and anti-parasitic properties. Thus, this group of drugs, which has an inhibitory effect on the growth of a wide variety of microorganisms, needs to be explored for syntheses of novel antimicrobial agents. The purpose of this review is to summarize the neuroleptic and antimicrobial properties of this exciting group of bioactive molecules with a goal of identifying potential structures worthy of future exploration.

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Chlorpromazine-induced severe exfoliative photoallergic reaction

Cited by 3 publications

References 9 publications

The phenomenon of phototoxicity and long-term risks of commonly prescribed and structurally diverse drugs

The phenomenon of phototoxicity and long-term risks of commonly prescribed and structurally diverse drugs

Antipsychotic-Related DRESS Syndrome: Analysis of Individual Case Safety Reports of the WHO Pharmacovigilance Database

A Double-Edged Sword: Thioxanthenes Act on Both the Mind and the Microbiome

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