Drew Mack, Nina Modanlo, Ingyun Park, Xiaofeng Yan, James Alan Bourgeois
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引用次数: 0
Abstract
Importance: Dermatologic and psychotropic therapies intersect frequently in patients with bipolar disorder, in whom systemic dermatologic medications may affect mood stability and mood stabilizers or antipsychotics may produce clinically important cutaneous adverse reactions. Because several medications discussed in this review are also used for psychotic disorders, severe or treatment-resistant major depressive disorder, suicidality, and other psychiatric conditions, this article distinguishes medication-related risks from considerations specific to bipolar disorder.
Observations: This narrative review synthesized English-language literature indexed in PubMed through June 29, 2026 addressing psychiatric adverse effects of dermatologic therapies and dermatologic adverse effects of psychotropic medications relevant to bipolar disorder. The literature consisted largely of case reports, case series, observational studies, pharmacovigilance analyses, and narrative or systematic reviews. No randomized controlled trials directly evaluating these bidirectional interactions in bipolar disorder were identified. Dermatologic agents such as isotretinoin, systemic corticosteroids, and methotrexate have been associated with mood destabilization in susceptible patients. Conversely, lithium and lamotrigine carry important dermatologic risks, including acneiform or psoriasiform eruptions, hidradenitis suppurativa, and severe cutaneous adverse reactions.
Conclusions and Relevance: Dermatologic-psychiatric drug interactions can be clinically significant and require careful screening, counseling, and longitudinal monitoring. Dermatologists, psychiatrists, and primary care clinicians should collaborate when initiating or modifying high-risk therapies, especially when psychiatric history, prior cutaneous drug reactions, polypharmacy, or rapid dose escalation increase risk.
Prim Care Companion CNS Disord2026;28(5):26nr04252.
Author affiliations are listed at the end of this article.
期刊介绍：
Founded in 1998, The Primary Care Companion for CNS Disorders (ISSN 2155-7780), formerly The Primary Care Companion to The Journal of Clinical Psychiatry, is an international, peer-reviewed, online-only journal, and its articles are indexed by the National Library of Medicine. PCC seeks to advance the clinical expertise of primary care physicians and other health care professionals who treat patients with mental and neurologic illnesses. PCC publishes research from disciplines such as medicine, nursing, pharmacy, and psychology, especially as it pertains to integrated delivery systems and interdisciplinary collaboration. PCC focuses on providing information of direct clinical utility and giving a voice to clinician researchers. Practice-based research from individuals and groups with clinical expertise is particularly welcome. Pertinent manuscript types include: -Original research -Systematic reviews -Meta-analyses -Case reports and series -Commenting letters to the editor Articles published in PCC typically cover attention-deficit/hyperactivity disorder, depression, bipolar disorder, anxiety, addiction, sleep disorders, pain, Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease.
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