psychopharmacological therapy

Psychopharmacological therapy plays a pivotal role in the management of psychodermatological conditions, where skin diseases are influenced or exacerbated by psychological factors. By addressing underlying psychiatric components, these therapies can significantly improve both dermatological symptoms and the overall well-being of patients.

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Common Psychotropic Medications Used in Dermatology

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Antidepressants​

• Selective Serotonin Reuptake Inhibitors (SSRIs): Examples include fluoxetine, sertraline, and escitalopram. SSRIs are effective for managing conditions like chronic itch, trichotillomania, and psychogenic excoriations. They reduce compulsive behaviors and improve mood, breaking the itch-scratch cycle.

• Tricyclic Antidepressants (TCAs): Examples include amitriptyline and doxepin. These agents have antihistaminic and sedative properties, making them particularly effective for nocturnal itch and chronic urticaria.

• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Drugs like duloxetine can be beneficial for patients with dermatological conditions accompanied by chronic pain, such as in atopic dermatitis or lichen simplex chronicus 

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Antipsychotics

• Antipsychotics are used for severe or refractory cases of delusions of parasitosis.

• Second-Generation Antipsychotics (SGAs): Drugs like risperidone, olanzapine, and aripiprazole are now preferred due to their better side effect profiles and efficacy in reducing delusional symptoms.

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Anxiolytics

• Anxiolytic medications help alleviate anxiety that often exacerbates skin conditions like psoriasis, acne, and eczema.

• Benzodiazepines: These short-term medications (e.g., lorazepam, clonazepam) can reduce acute stress and its dermatological impact. However, they are not recommended for long-term use due to the risk of dependence.

• Buspirone: A non-benzodiazepine anxiolytic, buspirone is useful for managing chronic anxiety in patients with psychodermatological disorders without the sedation risk of benzodiazepines.

 

Scientific Support for Psychotropic Medications in Dermatology​​

• Gupta, M. A., Vujcic, B., Pur, D. R., & Gupta, A. K. (2018). Use of antipsychotic drugs in dermatology. Clinics in dermatology, 36(6), 765–773. https://doi.org/10.1016/j.clindermatol.2018.08.006

• ​Weber, M. B., Recuero, J. K., & Almeida, C. S. (2020). Use of psychiatric drugs in Dermatology. Anais brasileiros de dermatologia, 95(2), 133–143. https://doi.org/10.1016/j.abd.2019.12.002​