Use of psychiatric drugs in Dermatology

Weber, Magda Blessmann; Recuero, Júlia Kanaan; Almeida, Camila Saraiva

doi:10.1016/j.abd.2019.12.002

Acessibilidade / Reportar erro

Brasil

Anais Brasileiros de Dermatologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Continuing Medical Education • An. Bras. Dermatol. 95 (2) • May-Jun 2020 • https://doi.org/10.1016/j.abd.2019.12.002 copy

Use of psychiatric drugs in Dermatology^☆ ☆ How to cite this article: Weber MB, Recuero JK, Almeida CS. Use of psychiatric drugs in Dermatology. An Bras Dermatol. 2020;95:133-43. , ^☆☆ ☆☆ Study conducted at the Dermatology Department, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Patients with psychocutaneous disorders often refuse psychiatric intervention in their first consultations, leaving initial management to the dermatologist. The use of psychotropic agents in dermatological practice, represented by antidepressants, antipsychotics, anxiolytics, and mood stabilizers, should be indicated so that patients receive the most suitable treatment rapidly. It is important for dermatologists to be familiar with the most commonly used drugs for the best management of psychiatric symptoms associated with dermatoses, as well as to manage dermatologic symptoms triggered by psychiatric disorders.

KEYWORDS
Antidepressive agents; Dermatology; Psychopharmacology; Psychosomatic medicine; Psychotropic drugs

Medication	Brand name	Presentation	Initial dose - maximum	Observations
Fluoxetine	Prozac, Daforin	10 and 20 mg tablet/capsule	10-80 mg/day	No monitoring required
		Oral solution 20 mg/mL		Extensive experience in pregnant women
		Oral solution 20 mg/mL		Long half life
Paroxetine	Paxil, Pondera, Aropax	10, 20, and 30 mg tablet	20-60 mg	No monitoring required
Sertraline	Tolrest, Zoloft, Assert	25, 50, and 100 mg tablet	25-200 mg	Used in patients with liver problems
Fluvoxamine	Luvox, Revoc	50 and 100 mg tablet	50-300 mg	Fractionize dose if > 150 mg/day
Citalopram	Celexa, Procimax	20 and 40 mg tablet	20-60 mg	Recommended in liver disease
Citalopram	Celexa, Procimax	20 and 40 mg tablet	20-60 mg	Higher cardiac risk at doses > 40 mg/day
Escitalopram	Lexapro, Reconter	5, 10, and 20 mg tablet	5-20 mg
Escitalopram	Lexapro, Reconter	Oral solution 20 mg/mL	5-20 mg

Medication	Brand name	Presentation	Initial dose - maximum	Observations
Nortriptyline	Pamelor	10, 25, 50, and 75 mg capsules	10-150 mg/day	EKG in women > 40 years and men > 30 years
Nortriptyline	Pamelor	Oral solution 2 mg/mL	10-150 mg/day	Safer for the elderly
Amitriptyline	Amytril, Tryptanol	10, 25, and 75 mg tablets	10-150 mg/day	EKG in women > 40 years and men > 30 years
Doxepin	Not available in Brazil	-	100-300 mg/day	Need to be formulated
Clomipramine	Anafranil	10, 25, and 75 mg tablet/dragée	10-250 mg/day	EKG in women > 40 years and men > 30 years
Clomipramine	Anafranil	Injectable solution 25 mg/2 mL	10-250 mg/day	EKG in women > 40 years and men > 30 years

Medication	Brand name	Presentation	Initial dose - maximum	Observations
Mirtazapine	Remeron, Zispin, Norset	15, 30, and 45 mg tablet	15-45 mg/day	Sedative
				Weight gain
				Anticholinergic effects (rare)
Bupropion	Wellbutrin, Wellbutrin XL Zetron, Zetron XL	150 and 300 mg tablet	150-300 mg/day	Slow or immediate release
Venlafaxine	Effexor, Zyvifax, Zaredrop	37.5, 50, 75, and 150 mg tablet/capsule	75-300 mg/day	Fractionized dose
Venlafaxine	Effexor, Zyvifax, Zaredrop	Oral solution 75 mg/mL	75-300 mg/day	Fractionized dose
Duloxetine	Velija, Cymbalta	30 and 60 mg tablet/capsule	60 mg/day	-
Trazodone	Donaren	50 and 100 mg tablet	150-600 mg/day	Sedative
				Fractionized doses above 300 mg/day
				Use in hospitalized patients

Medication	Brand name	Presentation	Initial dose - maximum
Pimozide	Orap	1 and 4 mg tablet	2-4 mg/day - 20 mg/day
Risperidone	Risperdal, Riss	1, 2, and 3 mg tablet 1 mg/mL solution	2 mg/day - 8 mg/day
Olanzapine	Zyprexa, Zopix	2.5, 5, and 10 mg tablet	2.5-5 mg/day - 15 mg/day
Quetiapine	Seroquel, Quetrox, Queropax	25, 100, and 200 mg tablet	25-750 mg/day
Aripiprazole	Aristab, Abilify	10, 15, 20, and 30 mg tablet	10-30 mg/day
Ziprasidone	Geodon	40 and 80 mg capsule	40-160 mg/day
Haloperidol	Haldol	1 and 5 mg tablet Oral solution 2 mg/mL Injectable solution 5 mg/mL	0.5-15 mg/day

Medication	Brand name	Presentation	Initial dose - Maximum	Observations
Lithium	Carbolitium	300 and 450 mg tablet	600-2.400 mg/day	Serum lithium level assessment is required
Lamotrigine	Lamitor, Lamictal	25, 50, and 100 mg tablet	50-200 mg/day	SJS/TEN
Carbamazepine	Tegretol, Tegrex, Carmazin, Tegretard	200 and 400 mg tablet	200-1600 mg/day	SJS/TEN (HLA-B1502 allele)
Carbamazepine	Tegretol, Tegrex, Carmazin, Tegretard	Oral solution 20 mg/mL	200-1600 mg/day	SJS/TEN (HLA-B1502 allele)
Sodium valproate	Depakote, Depakene	300 and 500 mg tablet	15-60 mg/kg/day	Hepatotoxicity
		250 mg/5 mL syrup		Pancreatitis
		250 mg/5 mL syrup		Teratogenic
Topiramate	Amato, Sigmax	25, 50, and 100 mg tablet	50-200 mg/day	Myopia, closed-angle glaucoma
				Metabolic acidosis
				Cognitive dysfunction
				Suicidal behavior
Pregabalin	Lyrica	75 and 150 mg capsule	150-600 mg/day	Suicidal behavior, convulsion in case of rapid withdrawal, angioedema
Gabapentin	Gabaneurin, Gamibetal, Progresse	300 and 400 mg capsule	900-3600 mg/day	-

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail:mbw@terra.com.br (M.B. Weber).

ANSWERS
Update on parasitic dermatoses. An Bras Dermatol. 2020;95(1):1-14.
1. b	3. b	5. c	7. b	9. d
2. c	4. d	6. c	8. c	10. a