PIGMENT DEPOSITION IN VISCERA ASSOCIATED WITH PROLONGED CHLORPROMAZINE THERAPY

Area of Science:

• Pharmacology
• Toxicology
• Dermatology

Background:

• Unexpected deaths occurred in young adult mental hospital patients undergoing prolonged chlorpromazine therapy.
• Some patients exhibited skin pigmentation and vision impairment, suggesting a potential adverse drug reaction.

Purpose of the Study:

• To investigate the cause of unexpected deaths and observed pigmentation in patients treated with chlorpromazine.
• To analyze the nature of the pigment and its distribution in the body.
• To explore the potential mechanism linking chlorpromazine to increased melanin production.

Main Methods:

• Autopsy of 12 physically healthy young adult patients who died unexpectedly.
• Histochemical and physical analysis of pigment deposits found in tissues.
• Assessment of melanocyte activity in the epidermis using the dopa tyrosinase reaction.

Main Results:

• Extensive melanin-like pigment deposits were found in macrophages (dermis, reticuloendothelial system) and parenchymal cells of internal organs.
• Increased melanocyte activity was observed in the epidermis.
• Five patients showed clinically obvious skin pigmentation; two also had vision impairment.

Conclusions:

• Chlorpromazine therapy is associated with increased melanin production and deposition in various tissues.
• The mechanism may involve chlorpromazine's effect on the autonomic nervous system, potentially blocking pigment-lightening factors like melatonin.
• Further investigation is warranted to fully elucidate the toxicological and physiological implications.