Ocular and cutaneous effects of chronic phenothiazine therapy

Bond, William S.; Yee, Gary C.

doi:10.1093/ajhp/37.1.74

Cited by 11 publications

(6 citation statements)

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“…This condition seems to be secondary to large dosages (>2 g/day) of the drug, and consists of swirling lines or fine streaks in the corneal epithelium. [6][7][8] It is not a serious condition because it does not cause visual impairment and tends to disappear, or at least diminish, after cessation of the drug.…”

Section: Phenothiazinesmentioning

confidence: 99%

“…chlorpromazine), and the resulting compounds show as lens discolouration. [3,6,61,62] Reversibility of these eye lesions is not always possible; it depends on the causative agent and on the degree of structural changes. [63][64][65] Visual disturbance varies, depending on the severity of the ocular changes.…”

Section: Cataract and Pigmentary Deposits In The Lens And Corneamentioning

confidence: 99%

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Ocular Adverse Effects of Common Psychotropic Agents

Richa¹,

Yazbek²

2010

CNS Drugs

178

143

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All psychotropic medications have the potential to induce numerous and diverse unwanted ocular effects. Visual adverse effects can be divided into seven major categories: eyelid and keratoconjunctival disorders; uveal tract disorders; accommodation interference; angle-closure glaucoma; cataract/pigmentary deposits in the lens and cornea; retinopathy; and other disorders. The disorders of the eyelid and of the keratoconjunctiva are mainly related to phenothiazines and lithium. Chlorpromazine, at high dosages, can commonly cause abnormal pigmentation of the eyelids, interpalpebral conjunctiva and cornea. It can also cause a more worrisome but rarer visual impairment, namely corneal oedema. Lithium can rarely lead to a bothersome eye irritation by affecting sodium transport. Uveal tract problems are mainly associated with tricyclic antidepressants (TCAs), typical antipsychotics, topiramate and selective serotonin reuptake inhibitors (SSRIs). TCAs, typical antipsychotics and SSRIs can all cause mydriasis that is often transient and with no major consequences, but that can promote closure of angles in susceptible patients. Topiramate has been frequently associated with a number of significant ocular symptoms including acquired myopia and angle-closure glaucoma. Problems with accommodation are related to TCAs and to low-potency antipsychotics. TCAs cause transient blurred vision in up to one-third of patients. Angle-closure glaucoma is a serious condition that has been mainly associated with TCAs, low-potency antipsychotics, topiramate and, to a lesser extent, SSRIs. When patients with narrow angles are given TCAs, they all appear to experience induction of glaucomatous attacks. Antipsychotics and SSRIs may lead to an added risk of developing angle-closure glaucoma, but only in predisposed eyes. Topiramate can lead to an allergic-type reaction whereby structures of the lens and ciliary body are displaced, which results in angle-closure glaucoma. Cataractous changes can result from antipsychotics, mainly from high dosages of chlorpromazine or thioridazine. These two drugs, when used at high dosages and for prolonged periods, frequently cause lenticular opacifications. Retinopathy has been shown to be related to high dosages of typical antipsychotics, mainly chlorpromazine and thioridazine. The frequency of occurrence of retinal effects seems to be proportional to the total amount of drug used over a long period of time. Other visual problems of special concern are the ocular dystonias, other eye movement disorders, and decreased ability to perceive colours and to discriminate contrast. Ocular dystonias can occur with antipsychotics (especially high-potency ones), carbamazepine (especially in polytherapy), topiramate and, rarely, with SSRIs. Disturbance in various eye movements is frequently seen with benzodiazepines, antiepileptic drugs and lithium. Impairment in the perception of colours and the discrimination of contrasts has been shown to occur not uncommonly with carbamazepine and lorazepam. Thus, typical antipsycho...

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Section: Phenothiazinesmentioning

confidence: 99%

Section: Cataract and Pigmentary Deposits In The Lens And Corneamentioning

confidence: 99%

Ocular Adverse Effects of Common Psychotropic Agents

Richa¹,

Yazbek²

2010

CNS Drugs

178

143

View full text Add to dashboard Cite

show abstract

“…Abnormal pigment accumulations related to chlorpromazine, especially dose of drugs used more than 2 grams daily, develops secondarily. [2][3][4] Typical antipsychotics also have effects on uveal tissues. Antipsychotics which have strong anticholinergic and/or antiadrenergic effects (such as chlorpromazine and fluphenazine) cause mydriasis and cycloplegia.…”

Section: Antipsychoticsmentioning

confidence: 99%

Psikotropik İlaçlar ve Oküler Yan Etkileri

Sönmez¹,

Aykan²

2014

tjo

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Nowadays, the number of patients using the types of drugs in question here has significantly increased. A study carried out in relation with the long-term use of psychotropic drugs shows that the consumption of this group of drugs has substantially increased in terms of variety and quantity. In this paper, we present our review of the literature pertaining to ocular complications of psychotropic drugs in long-term treatment profile of numerous patients. If the doctor and the patients are informed about the eye problems related to the use of psychotropic drugs, potential ocular complications can be easily prevented, supervised, and controlled and can even be reversed.

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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%