Pigmentation Due to Phenothiazines in High and Prolonged Dosage

Cataract occurrence in patients treated with antipsychotic drugs

“…6 In fact, chlorpromazine and other phenothiazinic antipsychotic drugs have been associated with cataract formation. 6,15,25,26 A factor that may have contributed to such a high rate in our study is the geographic location of Fortaleza, which is in an equatorial region with strong insolation (2.800 hours/ year) 27 since there is an association between cataract occurrence and solar exposure, 28,29 and the interaction between phenothiazines and the sunlight plays an essential role in cataract formation induced by these drugs. 17,18 A higher rate of cataract was observed in group 1, which used typical antipsychotic drugs at higher dosages for a longer duration when compared to group 2.…”

“…The literature has associated lens opacities with cumulative dosages and duration of exposure. 15,30,31 Some studies showed that chlorpromazine at 800 mg/day for 2 years is oculotoxic, 15 while in others, chlorpromazine at 200 mg/day over 2 years caused pigmentary deposits in the lens. 14 In addition, smoking has also been associated with cataract formation and the majority of the smoking patients belong to group 1.…”

“…[9][10][11][12] The dosage of chlorpromazine needed for inducing lenticular opacities has varied according to different studies. [13][14][15] Lenticular opacities associated with phenothiazinic typical antipsychotics are due to pigment deposition usually located in the anterior capsule and anterior subcapsular cortex.…”

Psychotropic Drugs and Ocular Side Effects

“…In 35 of 61 patients who have used 800 mg of chlorpromazine for two years have faced the development of pigment accumulation. 9 In another study, 33% of 384 patients using long term chlorpromazine have shown deposits in the lens and cornea. 10 However, there is not a finding of risk of high opacity creation subject to phenothiazines in relation with exact dose/period relation yet.…”

Photochemical Inactivation of Deoxyribonucleic and Ribonucleic Acid Viruses by Chlorpromazine

“…Chlorpromazine (Thorazine) is an extensively used tranquilizer often administered to humans therapeutically as an antipsychotic agent in oral doses of 10 to 2,000 mg/day (8,19). It has long been known as a photoallergen (9), and patients receiving daily doses in excess of 800 mg have experienced purple pigmentation of the skin upon exposure to sunlight (19).…”