Trial of lexapro (escitalopram) in non-depressed atopic dermatitis adults

Abstract

Rationale Recalcitrant Atopic Dermatitis (AD) patients maximally treated, were thought to have a stress triggered AD and possibly responsive to a SSRI. Methods Six Adults with refractory AD and not clinically depressed were started on escitalopram 10 mg daily for 6 weeks. AD severity was assessed via percent of skin involved using standard methods. After six weeks the patients were seen back at our clinic and assessed for AD via amount of reduction in skin involvement. Results After six weeks all 6 patients had at least some improvement. One patient had >25% reduction, three patients had >50% reduction and two patients had a >75% reduction in lesions. Three of the patients were stopped on escitalopram, and were 3 continued. All 3 patients who discontinued treatment returned to their pre-treatment state within three weeks. The other 3 patients elected to stay on therapy with continued good results for up to 3 months. No side effects or adverse events were noted by the patients. Conclusions Recently bupropion has been shown to be effective in AD patients by lowering TNF and studies have shown that a number of antidepressants have neuroendocrine and immunologic effects. Several potentially causative abnormalities in atopic dermatitis may be attenuated by an SSRI and may explain the observed salutary effects of this drug on our AD. Further research will be necessary to confirm our findings and to clarify possible mechanisms of action. The lack of side effects and tolerability of this medication may make it a reasonable adjunctive to a comprehensive AD treatment.