Acanthosis Nigricans During Treatment With Aripiprazole

Manu, Peter; Aldhaher, Zainab A.; Dargani, Navin; Correll, Christoph U.

doi:10.1097/mjt.0b013e3182491e29

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…Reports associate the use of aripiprazole with acanthosis nigricans, a dermatological correlate of insulin resistance. 41 Reports also associate aripiprazole with asymptomatic hyperamylasemia 42 and pancreatitiis. 43…”

Section: Adverse Effectsmentioning

confidence: 99%

Aripiprazole

Prommer

2016

Am J Hosp Palliat Care

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Delirium is a palliative care emergency where patients experience changes in perception, awareness, and behavior. Common features include changes in the sleep-wake cycle, emotional lability, delusional thinking, and language and thought disorders. Delirium results from neurotransmitter imbalances involving several neurotransmitters such as dopamine, glutamate, norepinephrine, acetylcholine, gamma-aminobutyric acid, and serotonin. Untreated delirium causes significant morbidity and mortality. Nonpharmacologic and pharmacologic approaches treat delirium. Current pharmacologic management of delirium involves using agents such as haloperidol or second-generation antipsychotics. Third-generation atypical antipsychotic drugs have emerged as a potential choice for delirium management. Aripiprazole is a third-generation antipsychotic with a dopamine receptor-binding profile distinct from other second-generation antipsychotics. Aripiprazole acts as partial agonist at dopamine D and 5-hydroxytryptamine (5-HT) receptors, stabilizing the dopamine receptor leading to improvement in symptoms. The article reviews the pharmacology, pharmacodynamics, metabolism, and evidence of clinical efficacy for this new antipsychotic agent. This article explores possible roles in palliative care.

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Section: Adverse Effectsmentioning

confidence: 99%

Aripiprazole

Prommer

2016

Am J Hosp Palliat Care

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“…Manu and colleagues reported on a 15‐year‐old medically healthy female admitted for a variety of comorbid psychiatric disorders who developed AN after treatment with Aripiprazole, an atypical antipsychotic drug 29 …”

Section: Resultsmentioning

confidence: 99%

“…A total of 13 acanthosis nigricans-inducing drugs were identified from the systematic literature search. These drugs included nicotinic acid, [4][5][6][7][8][9][10][11][12] niacinamide, 13 insulin, [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] aripiprazole, 29 oral corticosteroids, 12,30,31 somatotrophin, 32 oral contraceptives, 33 diethylstilbestrol, [34][35][36] testosterone, 37,38 pituitary extract of β-Melanocyte stimulating hormone (β-MSH), 39 triazinate, 40 amprenavir, 41 palifermin, 42,43 and fusidic acid ointment. 44 We discuss each drug in detail below and provide a summary in Table 1 15 3 months, 15 1 year, 16 3 months, 18 4 months 22…”

Section: Study Selectionmentioning

confidence: 99%

“…When the patient started to rotate his insulin injections and refrained from injecting the original areas of AN, these areas improved by 25% after 2 months. and colleagues reported on a 15-year-old medically healthy female admitted for a variety of comorbid psychiatric disorders who developed AN after treatment with Aripiprazole, an atypical antipsychotic drug 29. 3.6 | Oral corticosteroidsRandle and Winkelmann 31 reported on three patients with childhood dermatomyositis treated with oral triamcinolone who developed AN after 16.5, 1, and 8 years, respectively.…”

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confidence: 99%

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Drug‐induced acanthosis nigricans: A systematic review and new classification

Mourad

Haber

2021

Dermatologic Therapy

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Drug-induced acanthosis nigricans is an uncommon subtype of acanthosis nigricans and the data on this topic is not well understood by clinicians as it is presently limited in the literature. Previous reports of drug-induced acanthosis nigricans have simply consisted of a list of drugs possibly implicated in causing acanthosis nigricans. Several drugs listed are based on single case reports without biopsy confirmation, report of clearing on stopping the drug or reporting on whether acanthosis nigricans recurred with drug rechallenge. A comprehensive literature search was conducted using PubMed, EMBASE(Ovid), Cochrane Library, Scopus, and Web of Science electronic databases. The authors screened the initial result of the search strategy by title and abstract using the following inclusion criteria: eligible studies included those with patients who developed acanthosis nigricans secondary to a drug. This study is the first to comprehensively review the drugs that have been implicated in the development of acanthosis nigricans. A total of 38 studies were included in the systematic review, and a total of 13 acanthosis nigricans inducing drugs were identified. Nicotinic acid and insulin were the two most significant drugs that were reported to cause acanthosis nigricans. By using the results of this study, we created a revised classification system of drug-induced acanthosis nigricans which can be used as a concise framework for clinicians to refer to.

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“…22 Moreover, serious adverse effects of psychiatric medications-including type 2 diabetes, skin discoloration (acanthosis nigricans), and loss of control over facial motion (tardive dyskinesia), weight gain, increased cholesterol-were found to be more common than early data had indicated. [23][24][25] The underwhelming clinical efficacy coupled with emerging evidence of severe adverse effects sparked a renewed interest in novel therapies, prompting investigators to revisit previously published data on LSD and other psychedelic agents.…”

Section: Chemistry and Mechanism Of Actionmentioning

confidence: 99%

Psychedelic Therapy: A Primer for Primary Care Clinicians—Lysergic Acid Diethylamide (LSD)

Beutler,

Shinozuka,

Tabaac

et al. 2024

American Journal of Therapeutics

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Background: Lysergic acid diethylamide (LSD) is a hallucinogenic agent. In the mid-20th century, it was used to augment psychoanalysis and to treat alcohol use disorder. However, LSD was banned in 1970 in part because of concerns that it could bring about or exacerbate mental illness. Its therapeutic potential remains incompletely understood. Areas of Uncertainty: While uncontrolled recreational use of LSD can, in rare instances, lead to long-term psychosis, adverse events in clinical trials of LSD, such as anxiety, headache, and nausea, have almost always been mild and transient. Serious adverse events, such as intense panic, suicidal ideation, and psychosis, were reported in either none or very few of the participants. However, patient selection criteria, optimal dosing strategy, and appropriate clinical follow-up guidelines remain to be established. Therapeutic Advances: Preliminary data suggest that LSD may be effective for the management of alcohol use disorder, anxiety, and depression. In trials of LSD for treating anxiety and depression associated with life-threatening illnesses, 77% of participants demonstrate durable relief at 1 year post-treatment. Top-line data from a large-scale phase IIb trial (n = 198) indicate that 50% of participants experience remission from generalized anxiety disorder after a single 100 μg dose of LSD. According to a meta-analysis of RCTs on LSD from the mid-20th century, single-dose regimens of LSD significantly improve alcohol use disorder (P < 0.0003) with an odds ratio (OR) of 1.96. Limitations: Only one large-scale clinical trial (>50 participants) has been conducted on LSD in the contemporary era of psychedelic research. Further studies with large sample sizes are needed to explore potential clinical applications. Conclusions: Preliminary data suggest that LSD may be one of the most potent treatments for anxiety in patients both with and without a life-threatening illness. LSD may also be beneficial for treating depression and substance use disorders.

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Acanthosis Nigricans During Treatment With Aripiprazole

Cited by 6 publications

References 14 publications

Aripiprazole

Aripiprazole

Drug‐induced acanthosis nigricans: A systematic review and new classification

Psychedelic Therapy: A Primer for Primary Care Clinicians—Lysergic Acid Diethylamide (LSD)

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