Yuan Yiwen, Li Xiaoqing, Jiang Xingmei, Li Zhixiong, Ou Ying, Li Zhe
Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
People's Hospital of Jianyang City, Chengdu, China.
Front Psychiatry. 2022 Nov 4;13:948977. doi: 10.3389/fpsyt.2022.948977. eCollection 2022.
Ziprasidone is a second-generation antipsychotic drug commonly used to treat schizophrenia and bipolar disorder. Acne is a common inflammatory disease of sebaceous glands in adolescents that is often co-morbid with anxiety and depression, which may reduce treatment compliance. Through unknown mechanisms, ziprasidone may cause a range of inflammatory responses. Whether ziprasidone can cause acne in young patients with bipolar disorder has not been reported.
We report a 23-year-old woman with a 5-year history of bipolar disorder who experienced acne during use of ziprasidone. She was admitted to our hospital during 1-month aggravation of her symptoms and was diagnosed with bipolar I disorder (current or most recent episode of depression) with psychotic features. She was given ziprasidone and soon developed acne, which she never had before; the rash worsened substantially when the ziprasidone dose was increased. At the same time, levels of inflammatory factors increased. The rash resolved after ziprasidone therapy was stopped.
When prescribing ziprasidone to young people with bipolar disorder, clinicians should consider the potential for adverse skin reactions. It may be useful to assay levels of inflammatory markers during ziprasidone therapy and adjust the dose if necessary in order to ensure treatment compliance.
齐拉西酮是一种常用于治疗精神分裂症和双相情感障碍的第二代抗精神病药物。痤疮是青少年常见的皮脂腺炎症性疾病,常与焦虑和抑郁共病,这可能会降低治疗依从性。通过未知机制,齐拉西酮可能会引起一系列炎症反应。齐拉西酮是否会导致双相情感障碍年轻患者出现痤疮尚未见报道。
我们报告一名患有双相情感障碍5年的23岁女性,在使用齐拉西酮期间出现痤疮。她在症状加重1个月时入院,被诊断为伴有精神病性特征的双相I型障碍(当前或最近一次抑郁发作)。给予她齐拉西酮后很快出现痤疮,这是她以前从未有过的;当齐拉西酮剂量增加时,皮疹明显加重。同时,炎症因子水平升高。停用齐拉西酮治疗后皮疹消退。
在为双相情感障碍的年轻人开齐拉西酮处方时,临床医生应考虑皮肤不良反应的可能性。在齐拉西酮治疗期间检测炎症标志物水平并在必要时调整剂量可能有助于确保治疗依从性。