Phototoxic Reactions Induced by High Doses of Chlorpromazine and Thioridazine

Satanove, Abraham; McIntosh, John S.

doi:10.1001/jama.1967.03120160075010

Cited by 42 publications

(12 citation statements)

References 4 publications

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“…The side effects of neuroleptic drugs encompass effects on the entire group of neurons of this lineage (Table 4). [49][50][51][52][53] The most obvious side effects are involuntary movement disorders arising from the extrapyramidal system, many of which mimic the effects of Parkinson's disease and reflect the blockade of dopaminergic transmission between the dopaminergic neurons of the substantia nigra and the dorsal neostriatum. 9 Symptoms include dystonia, akathisia, bradykinesia, and tremor.…”

Section: Side Effectsmentioning

confidence: 99%

Schizophrenia

Freedman¹

2003

N Engl J Med

619

365

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Section: Side Effectsmentioning

confidence: 99%

Schizophrenia

Freedman¹

2003

N Engl J Med

619

365

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“…proposed that CPZ, when exposed to ultraviolet light, produces a free radical (7‐OH‐CPZ) which is purple in color. This free radical then combines with melanin to form a purple, amorphous material 12–15 …”

Section: Discussionmentioning

confidence: 99%

Photodistributed blue‐gray pigmentation of the skin associated with long‐term imipramine use

2002

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A 72-year-old white woman presented with progressively increasing slate-gray pigmentation of the face and extensor aspect of the forearms, which she had been suffering from for 8 years. She had been taking imipramine for approximately 30 years. Her other medications included ranitidine and anacin. Physical examination revealed slate-gray hyperpigmentation of the skin photodistributed on the face (Figs 1, 2) and extensor aspects of the forearms. Relative sparing of the skin folds, mucous membranes, sclerae, teeth, and nails was noted. The remainder of the physical examination revealed no abnormalities. Skin biopsy specimens from the right cheek and right forearm were obtained. Histologic examination revealed collections of variably sized, round to ovoid, yellow-brown globular deposits in the upper and mid dermis (Fig. 2). The deposits were identified within macrophages and free within the dermis. The epidermis was unremarkable and free of deposits. The deposits stained for melanin with a Fontana-Masson stain, but did not stain for iron.

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“…A total of 1.7% of 768 hospitalized schizophrenic patients were found to have skin pigment abnormalities 71 . Chlorpromazine and, less commonly, other phenothiazines cause a tan, blue‐grey, or slate‐grey pigmentation that is particularly prominent on sun‐exposed surfaces, as well as pigment deposits in the lens and cornea 72–81 . The cutaneous discoloration is most likely secondary to dermal granules containing melanin bound to the drugs or their metabolites 82 .…”

Section: Other Adverse Cutaneous Reactionsmentioning

confidence: 99%