Psychiatry and Clinical Psychopharmacology

Psychopharmacology Aripiprazole-induced exanthematous rash

Psychiatry and Clinical Psychopharmacology 2013; 23: Supplement S212-S213
Read: 512 Published: 18 March 2021

Dermatologic side effects of drugs are very common in clinical practice. Although dermatological side effects are commonly associated with psychotropic drugs like lamotrigine and lithium, other psychotropic drugs such as antidepressants and antipsychotics may also cause dermatological side effects. While these side effects can be treated by simple interventions; in some cases more serious side effects can be seen like Steve Johnson and Dress syndrome that have high mortality risk. Herein we present a case of exanthematous rash seen after aripiprazole usage. A 21-year-old, unemployed, single male patient. His first complaints were persecution and guiltiness delusions and auditory hallucinations about 5 years ago. He was diagnosed to have schizophrenia and hospitalized. After ECT (Electroconvulsive therapy) treatment, he was discharged with Risperdal Consta 50 mg and Solian 200 mg/day and remission is obtained by this treatment. Since the patient didn’t take his pills regularly, aripiprazole 15mg/day was added to his treatment. After the patient started to take Aripiprazole, exanthematous rash arised on the dorsum of his hand and got worsened in the following 15 days. He was consulted by dermatology clinic for this complaint. As this exanthematous rash was though to be associated with aripiprazole, aripiprazole treatment was discontinued. At the tenth day of discontinuation of aripiprazole, total recovery was seen on the exanthematous rash. His treatment was arranged with quetiapine 800mg/day, lithium 1800mg/day, Risperdal Consta 50mg and his symptoms remitted with this treatment. A literature search based on the key words “aripiprazole”, “exanthematous”, “eczema”, “rash” yields no case report about exanthematous rash associated with aripiprazole usage. In one case, papulopustular rash on the nose and forehead associated with aripiprazole usage was reported. There are few reports about aripiprazole associated hypersensitivity reactions as anaphylactic reaction, angioedema, nettle rash and pruritus. In another case alopecia, pruritus, erythrodermia and nettle rash related to Aripiprazole usage was reported.. This case is interesting because it is the first case associated with exanthematous rash caused by aripiprazole usage. It is important to follow patients carefully about rash associated with psychotropic drugs. While its treatment may be as easy as in our case, a more serious side effect can be seen like Steve Johnson or Dress syndrome. Generally it is enough to stop the treatment by the agent causing dermatological side effects for recovery of the dermatalogical symptoms.

EISSN 2475-0581