Imipramine-Associated Hyperpigmentation

Abstract

Clinicians need to be aware of rare adverse reactions such as hyperpigmentation, and be prepared to take appropriate and early action to prevent such reactions from becoming irreversible.

Imipramine‐induced hyperpigmentation: a case report and review of the literature

“…Through an extensive review of the English literature, only 13 cases of imipramine‐induced hyperpigmentation have been reported to date 8–16 . Imipramine‐induced hyperpigmentation was first described by Hare 14 in 1970 in a 46‐year‐old male with an 8‐year history of imipramine use.…”

Imipramine-Induced Facial Pigmentation: Case Report and Literature Review

“…Pigmentation was described as slate gray in six patients, 2-6 while others were described as brown, 4 golden-brown, 4 and purplish. 1,7 In all patients, the face was affected, while arms, 4 forearms, 2 neck, 1,3,4,7 and hands 3-6 were involved in some patients. Increased pigmentation of the iris was reported in two patients.…”

“…In one patient, stopping imipramine resulted in restoration of normal skin complexion within one year, 6 while another showed mild improvement after two years. 1 In another, patient switching to fluoxetine resulted in clearing of pigmentation in six months. 4 One case described switching to amytriptilline, another tricyclic antidepressant, which resulted in clearing one year later, 4 suggesting that individual tricyclic compounds may vary in their ability to induce pigmentation.…”

“…[1][2][3][4][5][6][7] All were adults treated for depression, their ages ranging from 46 to 75 years. It should be noted that nine patients were female, 2-6 perhaps reflecting the higher incidence of depression in women.…”

“…[4][5][6] There were also two patients who had pigmentation changes of their sclera that was reported to have amber 5 and brownish discoloration. 1 The outcome was specified in six patients. In one patient, stopping imipramine resulted in restoration of normal skin complexion within one year, 6 while another showed mild improvement after two years.…”