Dhungel Omkar, Amatya Indra Prasad, Sharma Pawan
Institute of Medicine Patan Academy of Health Sciences, Lalitpur, Nepal.
Case Rep Psychiatry. 2024 Aug 7;2024:7416277. doi: 10.1155/2024/7416277. eCollection 2024.
Hyperpigmentation is a common side effect of different drugs with many of these having a well-explained mechanism and some even having a characteristic distribution. However, it is a rare side effect of sertraline, a selective serotonin reuptake inhibitor (SSRI), with only a few reported cases. In addition, there are no specific characteristics of the lesions or the risk factors. . This is a case report of a 24-year-old male with panic disorder, who developed hyperpigmentation over the face after 5 days of increasing the dosage of sertraline to 100 mg/day. There were no other significant findings from the physical examination or investigations. The patient was treated as a case of sertraline-induced hyperpigmentation, and the dose was reduced to 75 mg/day and maintained at 50 mg/day after 1 week along with tablet propranolol 20 mg/day. He was also prescribed tablet tranexamic acid 500 mg/day and sunscreen with sun protection factor 50. The hyperpigmentation disappeared within 2 months, and the medication was gradually tapered after 7 months of treatment.
Hyperpigmentation is a rare but distressing side effect of sertraline. It is a potentially curable side effect if recognized early. Early recognition and intervention can decrease unnecessary investigations and treatment. There are limited studies highlighting this unusual adverse effect of this commonly used SSRI. Hence, further studies are needed to better understand various aspects of this condition including the characteristics, patients at risk, and possible management. The development of diagnostic and treatment guidelines would decrease the dilemma of identification and management.
色素沉着是不同药物常见的副作用，其中许多药物的作用机制已得到充分解释，有些甚至具有特征性分布。然而，它是选择性5-羟色胺再摄取抑制剂（SSRI）舍曲林罕见的副作用，仅有少数病例报道。此外，这些病变没有特定特征或风险因素。本文报告一例24岁患有惊恐障碍的男性患者，在将舍曲林剂量增加至100mg/天后5天，面部出现色素沉着。体格检查和调查未发现其他重要异常。该患者被诊断为舍曲林引起的色素沉着，剂量减至75mg/天，1周后维持在50mg/天，并加用普萘洛尔片20mg/天。还给他开了氨甲环酸片500mg/天和防晒系数为50的防晒霜。色素沉着在2个月内消失，治疗7个月后药物逐渐减量。
色素沉着是舍曲林罕见但令人苦恼的副作用。如果早期识别，这是一种潜在可治愈的副作用。早期识别和干预可以减少不必要的检查和治疗。突出这种常用SSRI这种不寻常不良反应的研究有限。因此，需要进一步研究以更好地了解这种情况的各个方面，包括特征、高危患者和可能的处理方法。制定诊断和治疗指南将减少识别和处理的困境。
