SSRI‐induced severe adverse cutaneous reaction – a case report

Byrne, Andrew; Arkell, Sian; Bandi, Priya

doi:10.1002/pnp.479

Cited by 4 publications

(13 citation statements)

References 18 publications

(23 reference statements)

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“…In another case report, fluoxetine was thought to be the cause of acute urticaria and angioedema in a 23-year-old male [107]. Rarely, serious cutaneous reactions such as Stevens-Johnson syndrome, toxic epidermal necrosis, erythema multiforme, acute generalized exanthematous pustulosis, and drug-induced hypersensitivity reactions have been reported in patients taking SSRIs [108][109][110]. These conditions may be life-threatening, stressing the importance of patient and provider education in recognizing adverse cutaneous reactions early [108].…”

Section: Rashmentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review

Edinoff

Akuly

Hanna

et al. 2021

Neurology International

152

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Depression is the most prevalent psychiatric disorder in the world, affecting 4.4% of the global population. Despite an array of treatment modalities, depressive disorders remain difficult to manage due to many factors. Beginning with the introduction of fluoxetine to the United States in 1988, selective serotonin reuptake inhibitors (SSRIs) quickly became a mainstay of treatment for a variety of psychiatric disorders. The primary mechanism of action of SSRIs is to inhibit presynaptic reuptake of serotonin at the serotonin transporter, subsequently increasing serotonin at the postsynaptic membrane in the serotonergic synapse. The six major SSRIs that are marketed in the USA today, fluoxetine, citalopram, escitalopram, paroxetine, sertraline, and fluvoxamine, are a group of structurally unrelated molecules that share a similar mechanism of action. While their primary mechanism of action is similar, each SSRI has unique pharmacokinetics, pharmacodynamics, and side effect profile. One of the more controversial adverse effects of SSRIs is the black box warning for increased risk of suicidality in children and young adults aged 18–24. There is a lack of understanding of the complexities and interactions between SSRIs in the developing brain of a young person with depression. Adults, who do not have certain risk factors, which could be confounding factors, do not seem to carry this increased risk of suicidality. Ultimately, when prescribing SSRIs to any patient, a risk–benefit analysis must factor in the potential treatment effects, adverse effects, and dangers of the illness to be treated. The aim of this review is to educate clinicians on potential adverse effects of SSRIs.

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Section: Rashmentioning

confidence: 99%

Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review

Edinoff

Akuly

Hanna

et al. 2021

Neurology International

152

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show abstract

“…Compared to SSRIs, SNRIs induce more nausea, insomnia, dry mouth in addition to raising blood pressures and sexual dysfunction 8,7 . Although less commonly cited, SSRI‐induced cutaneous adverse drug reactions (CADRs) are increasingly being recognised as a class effect 9 . A Swedish study highlighted that dermatologic ADRs account for up to 11.4% of all SSRI attributed ADRs.…”

Section: Introductionmentioning

confidence: 99%

“…8,7 Although less commonly cited, SSRI-induced cutaneous adverse drug reactions (CADRs) are increasingly being recognised as a class effect. 9 A Swedish study highlighted that dermatologic ADRs account for up to 11.4% of all SSRI attributed ADRs. Rashes were characterised as maculopapular, vesiculo-bullous, erythematous or unspecified rash contributed 7.5% of all SSRI attributed ADRs with a median time to onset of 5 days.…”

Section: Introductionmentioning

confidence: 99%

Selective serotonin reuptake inhibitor and serotonin‐norepinephrine reuptake inhibitor associated cutaneous adverse drug reactions: A systematic review of case reports and case series

et al. 2021

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Anecdotal evidence suggests that selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) cause cutaneous adverse drug reactions (CADRs). However, there is limited information on the factors associated with these occurrences. In this study, we aimed to describe the demographic, clinical and pharmacological characteristics associated with CADRs encountered by patients administered SSRIs and/or SNRIs for psychiatric diagnoses and to compare the differences in these factors between severe and nonsevere CADRs. A protocol was developed a priori (PROSPERO: CRD42020204830) in line with the PRISMA guidelines. We searched PubMed/Medline, PsycINFO and SCOPUS from inception to October 2020 to identify case reports and/or case series of SSRI and SNRI associated CADRs. Additional cases were obtained from the retrieved articles' bibliography. A total of 141 articles were included in the study, documenting 173 CADRs. Females accounted for 128 (74.0%) of the analysed CADRs. The median age of the cases was 42 IQR (27; 53) with no statistically significant differences in age between males and females (P = 0.542). A total of 157 (90.8%) of the reported CADRs were associated with SSRIs, particularly fluoxetine 68 (39.5%), sertraline 30 (17.4%) and paroxetine 25 (14.5%). Non-severe CADRs and severe CADRs accounted for 23 (13.4%) and 149 (86.6%) reports respectively. No statistically significant differences were observed for gender (P = 0.616), age at onset (P = 0.493) and time to onset (P = 0.105) between non-severe CADRs and SCARs. In conclusion, CADRs following SSRIs and SNRIs disproportionately affect females in the reproductive age group compared to males and are mostly associated with SSRIs. Abbreviations: AGEP acute generalised exanthematous pustulosis CADRs cutaneous adverse drug reactions MDD major depressive disorders SNRIs serotonin and norepinephrine reuptake inhibitors SSRIs selective serotonin reuptake inhibitors TCAs tricyclic antidepressants

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“…The side‐effect profile of SSRIs is well characterised, the most notable features including sleepiness, weight gain, gastrointestinal effects, and sexual dysfunction 2 . Cutaneous adverse reactions, although recognised, appear to be relatively rare, although they can sometimes be serious 3,4 . A patient is reported with SSRI‐related skin reaction in whom removal of a possible precipitating cause, rather than drug cessation or switching, resolved the problem.…”

mentioning

confidence: 99%

“…2 Cutaneous adverse reactions, although recognised, appear to be relatively rare, although they can sometimes be serious. 3,4 A patient is reported with SSRI-related skin reaction in whom removal of a possible precipitating cause, rather than drug cessation or switching, resolved the problem.…”

mentioning

confidence: 99%

Chocolate coating: managing an SSRI‐related adverse cutaneous reaction

Gahir¹

2021

Prog Neurol Psychiatry

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SSRI-related cutaneous reaction I Case notes S elective serotonin reuptake inhibitors (SSRIs) are widely prescribed for the treatment of anxiety and depression. Guidance for their use has been published by the National Institute for Health and Care Excellence (NICE), 1 and updated guidance is awaited. The side-effect profile of SSRIs is well characterised, the most notable features including sleepiness, weight gain, gastrointestinal effects, and sexual dysfunction. 2 Cutaneous adverse reactions, although recognised, appear to be relatively rare, although they can sometimes be serious. 3,4 A patient is reported with SSRI-related skin reaction in whom removal of a possible precipitating cause, rather than drug cessation or switching, resolved the problem.

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SSRI‐induced severe adverse cutaneous reaction – a case report

Cited by 4 publications

References 18 publications

Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review

Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review

Selective serotonin reuptake inhibitor and serotonin‐norepinephrine reuptake inhibitor associated cutaneous adverse drug reactions: A systematic review of case reports and case series

Chocolate coating: managing an SSRI‐related adverse cutaneous reaction

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