Psychotropic drugs in dermatology: a review and guidelines for use

A review of the literature on the use of psychotropic drugs in dermatologic practice--including the antipsychotic, antidepressant, antianxiety, and hypnotic medications, as well as their pharmacologic properties, guidelines for clinical use, and a profile of adverse effects--is presented. After adverse effects and current guidelines for use are taken into consideration, it is suggested that psychotropic drugs be restricted to dermatologic conditions with clearly discernible psychiatric symptoms, for example, psoriasis and major depression, vitiligo resulting in social anxiety, and delusions of parasitosis. The pharmacologic properties of psychotropic drugs, such as the analgesic properties of certain antidepressants, may be of benefit in the treatment of dermatologic symptoms such as intractable pruritus, since pain and pruritus share the same central nervous system pathways. This use of psychotropic drugs remains to be evaluated by well-designed clinical trials.