Case Report
Volume 4 Issue 3
Ranit Bag*
February 22, 2024
Abstract
A 26 year old male patient complained of appearance of itching, painful white plaque like lesion over right sole prescribed all antipsychotic medications (fluoxetine (60mg), lithium (450 mg), aripiprazole(2mg) and propranolol for last 3months); adding clozapine (5mg) in place of aripiprazole. Then he was prescribed all the medications instead of olanzapine (10 mg) in place of clozapine and fluvoxamine (100 mg) in place of fluoxetine. After 3months, he developed existing itching and painful plaque like lesions with urinary hesitancy, tremor and insomnia. Then he was advised to withdraw all the medications for at least 1month and somatic disorders were treated with combined tab pregabalin and methylcobalamine, multivitamin. Psoriatic lesion was treated by topical corticosteroid and oral cyclosporine (100mg once weekly for 1months).
Naranjo causality assessment score was 5 and it was scored as probable in WHO-UMC scale. These type of effects were minimized by dechallenging of the culprit drugs and symptomatic management.
Keywords: Antipsychotic; Plaque like lesion; tremor; insomnia; psoriatic lesion; Naranjo; WHO-UMC; dechallenging
Reference