THERAPY OF CHLORPROMAZINE MELANOSIS - PRELIMINARY REPORT

  • 1 January 1964
    • journal article
    • research article
    • Vol. 91  (12) , 636-+
Abstract
Melanosis observed in association with prolonged chlorpromazine therapy has become a serious problem in mental institutions. Skin pigmentation has produced an appearance which is cosmetically undesirable. Ocular deposits have caused visual impairment. Diffuse visceral involvement has been accompanied by functional disturbances of the involved organs. Withholding chlorpromazine did not diminish the pigment deposits already present in eight patients with chlorpromazine-induced melanosis. Therefore therapy for existing cases and means of preventing this side effect were investigated. A method of blocking melanin synthesis by depressing tyrosinase activity was devised. A Cu chelating agent, D-penicillamine, was administered for a period of 4 weeks (300 mg 3 times daily for 6 days each week, with mineral supplement substituted on the seventh day). Four of 6 patients thus treated improved markedly as evidenced by diminution of skin pigmentation. Urinary Cu excretion was substantially increased during the trial period. An alternative method of treatment designed to stimulate melatonin production by the pineal gland was employed. Two patients were kept in darkness for a period of 4 weeks. One improved markedly, the other only slightly.