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To the Editor.—
I have had extensive experience with the use of fluorouracil (Efudex) cream in treating actinic keratoses during the last eight years. I have observed that approximately 25 of every 100 patients treated will have a mild-to-moderate mental depression occurring at the peak of the irritative response. This reaction is slightly more common in women. Affected patients usually have extreme fatigue and lethargy that lasts five to seven days. Some of these patients will complain of easy irritability, short temper, and excessive crying.When use of the fluorouracil cream is discontinued and signs of healing begin to appear, the depressive symptoms rapidly clear within several days.
Report of a Case.—
An otherwise stable 52-year-old woman experienced emotional changes while being treated with fluorouracil cream. A moderate inflammatory reaction developed after ten days of application. Her discomfort was about average. On the 11th day of treatment, she went into
Milstein HG. Mental Depression Secondary to Fluorouracil Therapy for Actinic Keratoses. Arch Dermatol. 1980;116(10):1100. doi:10.1001/archderm.1980.01640340010002