Use of antipsychotic drugs in dermatology

Gupta, Madhulika A.; Vujcic, Branka; Pur, Daiana R.; Gupta, Aditya K.

doi:10.1016/j.clindermatol.2018.08.006

Cited by 21 publications

(12 citation statements)

References 60 publications

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“…In dermatology, antipsychotics are mainly prescribed to treat patients with primary psychodermatological conditions such as delusions of parasitosis or other conditions in which the skin symptoms are thought to be driven by psychosis. 15 In our survey, the most commonly reported antipsychotic agent was risperidone, followed by pimozide. The latter is a high potency typical antipsychotic medication that traditionally was the drug of choice for treatment of delusions of parasitosis.…”

Section: Discussionmentioning

confidence: 73%

Psychodermatology in Canada: A National Survey Assessment of Dermatologists’ Perception, Practice Patterns, and Challenges

et al. 2020

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Objectives We aimed to assess the perception of psychodermatology, practice patterns, and challenges reported by Canadian dermatologists. Methods We designed an online questionnaire based on previous literature, including questions about practitioners’ perceptions, practice patterns, training, and challenges in psychodermatology. We solicited their opinions on desired training, research needs, and clinical approach recommendations. Our survey was distributed nationally by the Canadian Dermatology Association (CDA). Results Of the total of 78 participating dermatologists, >75% reported treating patients with psychodermatological conditions, with higher frequencies of secondary than primary psychodermatological conditions. While practitioners had some confidence in their understanding of psychodermatology (median = 4 on a 5-point scale), their comfort levels to approach these patients were lower (median = 3), and their confidence in prescribing psychotropic medication was markedly low (median = 2). A total of 50% reported that a “multidisciplinary approach” would be best for these patients. Poor access to psychiatry was the most reported (26.9%) challenge, together with time constraints, lack of training, poor communication with patients, and lack of patient insight and resources. While 46.2% reported having never participated in psychodermatology training, 55.1% expressed interest in doing so. Conclusion We identified several challenges with knowledge, awareness, and healthcare delivery in psychodermatological practice in Canada. Increasing dermatologists’ access to psychiatric consultations/services, a multidisciplinary approach with dermatologists and psychiatrists co-providing care, and more specialized training in this area are recommended to narrow the identified gaps.

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Section: Discussionmentioning

confidence: 73%

Psychodermatology in Canada: A National Survey Assessment of Dermatologists’ Perception, Practice Patterns, and Challenges

et al. 2020

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“…The results of the present study indicated that concurrent blockade of both pathways may be efficacious, but at the expense of possible toxicity, which requires further investigation. It is known that pimozide may cause signs of an allergic reaction: Urticaria, swelling of your face, lips, tongue (45). Bromocriptine may cause some unwanted effects including dizziness and nausea (46).…”

Section: Discussionmentioning

confidence: 99%

Pimozide augments bromocriptine lethality in prolactinoma cells and in a xenograft model via the STAT5/cyclin D1 and STAT5/Bcl‑xL signaling pathways

et al. 2020

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As hyperprolactinemia is observed in patients with bromocriptine-resistant prolactinoma, prolactin (PRL) has been implicated in the development of bromocriptine resistance. Since PRL primarily mediates cell survival and drug resistance via the Janus kinase-2 (JAK2)/signal transducer and activator of transcription 5A (STAT5) signaling pathway, the STAT5 inhibitor, pimozide, may inhibit cell proliferation and reverse bromocriptine resistance in prolactinoma cells. In the present study, compared with bromocriptine or pimozide alone, the combination of pimozide and bromocriptine exerted enhanced reduction in cell growth and proliferation, and increased apoptosis and cell cycle arrest in bromocriptine-resistant prolactinoma cells. A reduction in phospho-STAT5, cyclin d1 and B-cell lymphoma extra-large (Bcl-xL) expression levels were observed in cells treated with the combination of drugs. In addition, pimozide suppressed spheroid formation of human pituitary adenoma stem-like cells, and reduced the protein expression of the cancer stem cell markers, cd133 and nestin. Pimozide did not exert any additional antitumor activity in STAT5-knockdown primary culture cells of human bromocriptine-resistant prolactinomas. Furthermore, Pimozide combined with bromocriptine treatment significantly reduced human prolactinoma xenograft growth. Western blot and immunohistochemical analyses also demonstrated significant inhibition of cell proliferation and stem cell marker proteins in vivo. collectively, these data indicated that pimozide treatment reduced prolactinoma growth by targeting both proliferating cells and stem cells, at least in part, by inhibiting the STAT5/Bcl-xL and STAT5/cyclin d1 signaling pathways.

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“…Over the years, administration of pimozide as a first-line treatment option has lost its importance due to concerns about its safety profile, its prolongation of the QTc interval, and a high risk of extrapyramidal symptoms [12]. A double-blind, placebo-controlled crossover trial comprising 11 patients with delusional parasitosis was performed in which the effects of pimozide were evaluated.…”

Section: Methodsmentioning

confidence: 99%

Delusions of Parasitosis: An Update

Reich

Kwiatkowska

Pacan³

2019

Dermatol Ther (Heidelb)

100

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Delusional parasitosis, also known as delusional infestation or Ekbom syndrome, is a relatively infrequent psychotic disorder characterized by an unwavering false belief that there is a parasitic infestation of the skin, despite the absence of any medical evidence that could support this claim. Delusional parasitosis can be categorized into primary, secondary, and organic forms. Sometimes, close relatives also experience identical delusions. This phenomenon was reported to occur in 5–15% of cases, and is known as shared psychotic disorder–delusional parasitosis with folie à deux. Patients with delusional parasitosis frequently seek help from many physicians. Close multidisciplinary cooperation between clinicians is often key to shortening the time taken to diagnose this disorder. Initiation of psychopharmacological therapy is a challenge, as many patients refuse any psychiatric treatment because of the stigma associated with mental illness and because of their firm belief that they have a parasitic infestation, not a psychiatric condition. For many patients, a sense of a lack of understanding leads to isolation and the development of depression symptoms, which is why it is crucial to earn the trust of such patients while taking care of them.

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Use of antipsychotic drugs in dermatology

Cited by 21 publications

References 60 publications

Psychodermatology in Canada: A National Survey Assessment of Dermatologists’ Perception, Practice Patterns, and Challenges

Psychodermatology in Canada: A National Survey Assessment of Dermatologists’ Perception, Practice Patterns, and Challenges

Pimozide augments bromocriptine lethality in prolactinoma cells and in a xenograft model via the STAT5/cyclin D1 and STAT5/Bcl‑xL signaling pathways

Delusions of Parasitosis: An Update

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