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Neurological and Neuropsychiatric Adverse Effects of Dermatologic Medications

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Abstract

Severe, recalcitrant dermatologic conditions often require systemic treatment. Although efficacious, these medications have been associated with wide-ranging adverse reactions. Some are reversible, predictable, and either dose-dependent or treatment length-dependent, while others are unpredictable, irreversible, and potentially fatal. This review examines the neuropsychiatric adverse effects associated with US FDA-approved medications for treatment of the following dermatologic pathologies that typically require systemic therapy: autoimmune dermatoses, acne, psoriasis, and melanoma. A search of the literature was performed, with adverse effects ranging from mild headaches and neuropathy to severe encephalopathies. The medications associated with the most serious reactions were those used to treat psoriasis, especially the older non-biologic medications such as cyclosporine A and methotrexate. Given the importance of these systemic dermatologic therapies in treating severe, recalcitrant conditions, and the wide variety of potentially serious neuropsychiatric adverse effects of these medications, neurologists, psychiatrists, dermatologists, oncologists, and primary care providers must be aware of the potential for these neuropsychiatric adverse reactions to allow for appropriate counseling, management, and medication withdrawal.

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Authors and Affiliations

  1. Baylor College of Medicine, Houston, TX, USA

    Melinda Liu & Yuan Yu M. Huang

  2. Department of Dermatology, Baylor College of Medicine, Houston, TX, USA

    Sylvia Hsu

  3. Department of Neurology, Baylor College of Medicine, 7200 Cambridge Street, 9th Floor, Houston, TX, 77030, USA

    Joseph S. Kass

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  1. Melinda Liu
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  2. Yuan Yu M. Huang
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  3. Sylvia Hsu
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Correspondence to Joseph S. Kass.

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Conflict of interest

Dr. Hsu has been an advisory board member for Abbvie, Amgen, Janssen, Eli Lilly, Novartis, and Valeant, and receives honoraria from these companies. Ms. Liu, Mr. Huang, and Dr. Kass have no conflicts of interest to declare.

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Liu, M., Huang, Y.Y.M., Hsu, S. et al. Neurological and Neuropsychiatric Adverse Effects of Dermatologic Medications. CNS Drugs 30, 1149–1168 (2016). https://doi.org/10.1007/s40263-016-0392-x

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