Adverse Cutaneous Reactions to Antipsychotics

The document from 2002 reviewed adverse cutaneous reactions to antipsychotic medications, reporting that about 5% of patients experience such effects, which range from benign and manageable to severe and life-threatening. Common reactions include pruritus, exanthematous eruptions, urticaria, fixed drug eruptions, photosensitivity, drug-induced pigmentation, and alopecia, with severe reactions like erythema multiforme, Stevens-Johnson Syndrome, and exfoliative dermatitis being rare. Drug-induced pigmentation and alopecia were specifically noted, with pigmentation occurring after long-term use of phenothiazines and alopecia being a diffuse, nonscarring hair loss that typically resolves within 2 to 5 months after discontinuation of the medication. The document stressed the importance of early recognition and management of severe reactions, including stopping the offending medication, and balancing the therapeutic benefits against the risks of mild reactions when deciding on treatment continuation.