Antipsychotic-Induced Euprolactinemic Galactorrhea in an Adolescent Girl

Kwak, Woo Jin; Patel, Ankit; Haq, Fasiha; Siddiqui, Fatima; Younis, Mohammad; Raza, Shakeel; Gholkar, Radhika

doi:10.4088/pcc.11l01239

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…Among the second-generation antipsychotics, risperidone and amisulpride were reported to cause a marked and sustained increase in serum prolactin levels in other studies[1819] and a similar trend were observed in our study also. The time to onset of galactorrhea was ranged from 4 to 75 days after commencement of amisulpride.…”

Section: Discussionsupporting

confidence: 91%

Identification and management of adverse effects of antipsychotics in a tertiary care teaching hospital

Lucca¹,

Ramesh²,

Parthasarathi³

et al. 2014

J Res Pharm Pract

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Objective:Antipsychotics have revolutionized psychiatry by allowing significant numbers of patients in long-term hospital settings to be discharged and successfully maintained in the community. However, these medications are also associated with a range of adverse events ranging from mostly annoying to rarely dangerous. This study is carried out to identify the adverse drug reactions (ADRs) to antipsychotics and its management in psychiatric patients.Methods:Prospective interventional study was conducted in the psychiatric unit of a tertiary care hospital. Patients of any age and either sex prescribed with at least one antipsychotic were included and monitored for ADRs.Findings:Among the 517 patients receiving antipsychotics, a total of 289 ADRs were identified from 217 patients at an overall incidence rate of 41.97%. Sixty-seven different kinds of ADRs were observed in the study patients. Central and peripheral nervous system was the most commonly affected system organ class (n = 59) and weight gain (n = 30) was the most commonly observed ADR. Olanzapine was most commonly implicated in reported ADRs (n = 92) followed by risperidone (n = 59). Of the 289 ADRs, 80% required interventions including cessation of drug and/or specific/symptomatic/nonpharmacological treatment.Conclusion:This post marketing surveillance study provides a representative data of the ADR profile of the antipsychotics likely to be encountered in psychiatric patients in an Indian tertiary care hospital.

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Section: Discussionsupporting

confidence: 91%

Identification and management of adverse effects of antipsychotics in a tertiary care teaching hospital

Lucca¹,

Ramesh²,

Parthasarathi³

et al. 2014

J Res Pharm Pract

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“…Euprolactinemic galactorrhea has been reported in patients using antipsychotic drugs, such as quetiapine, imipramin, escitalopram, risperidon, and fluvoxamine (7)(8)(9). The euprolactinemic status of our case suggests an unusual alternative mechanism of domperidone-induced galactorrhea.…”

Section: Discussionmentioning

confidence: 53%

Euprolactinemic galactorrhea secondary to domperidone treatment

Demir

Kuloğlu

Berberoğlu

et al. 2015

Journal of Pediatric Endocrinology and Metabolism

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Milk leakage from the breast, which is known as galactorrhea, can be caused by a number of pharmacological, physical, and tumoral factors. Galactorrhea is a well-known side effect of domperidone, and is usually associated with hyperprolactinemia. However, euprolactinemic galactorrhea secondary to domperidone is very rarely seen and has yet to be reported in children before. Here, we report an adolescent with euprolactinemic galactorrhea caused by domperidone.

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“…Obesity with eczema [13] , hypothyroid [14] Drugs GI: rabeprazole, domperidone [14,15] Psychiatric: duloxetine [16] , paroxetine [17] . quetiapine [18,19] , venlafaxine [20] , risperidonefluvoxamine combination [21] , ziprasidone [22] , escitalopram [23] , imipramine and escitalopram [24] Hormones: oral contraceptives [25] , depot medroxyprogesterone acetate [26] Miscellaneous chest wall surgery [27] , breast reduction surgery [6] , copper containing IUD [28] Hypothalamic pituitary gonadal axis may also play an important role in the development of normoprolactinemic galactorrhea. Decrease in basal gonadotropin levels, lack of episodic secretion of LH [33] or blunted response of gonadotropins (FSH and LH) to gonadotropin releasing hormone (GnRH) [34] may contribute to the development of galactorrhea in normoprolactinemic patients.…”

Section: Endocrinementioning

confidence: 99%

“…Serotonin receptors play a role in regulation of neurotransmitter release including dopamine (prolactin inhibiting factor) and serotonin is an indirect modulator of prolactin secretion. [18] The last, but not the least, important mechanism affecting hypothalamic dopamine secretion, prolactin secretion and probably prolactin function is the change in intracranial pressure. Based on the development of hyperprolactinemia and galactorrhea seen in traumatic brain hemorrhage, [7] spontaneous intracranial hypotension [18] and in normoprolactinemic galactorrhea with primary low cerebrospinal fluid pressure syndrome, [9] we may speculate that the change in the intracranial pressure can lead to mechanical or biochemical cascade that can cause hypothalamic or pituitary inflammation or irritation which may affect prolactin secretion or prolactin function.…”

Section: Endocrinementioning

confidence: 99%

A case of normoprolactinemic galactorrhea following aneurysmal subarachnoid hemorrhage

Asadipooya

2018

CRIM

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Galactorrhea is most commonly associated with elevated levels of prolactin; however, it does happen in individuals whose prolactin level is within normal range. Galactorrhea has been reported after neurosurgical procedures, cranial trauma or cerebral hemorrhage affecting the hypothalamus, pituitary or pituitary stalk, but these were associated with elevated levels of prolactin. In our knowledge, there has not been a case reported wherein a patient developed normoprolactinemic galactorrhea after an aneurysmal subarachnoid hemorrhage. The etiology and pathophysiology of normoprolactinemic galactorrhea have not been distinctly defined making this entity a diagnostic and therapeutic challenge for physicians.

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Antipsychotic-Induced Euprolactinemic Galactorrhea in an Adolescent Girl

Cited by 3 publications

References 22 publications

Identification and management of adverse effects of antipsychotics in a tertiary care teaching hospital

Identification and management of adverse effects of antipsychotics in a tertiary care teaching hospital

Euprolactinemic galactorrhea secondary to domperidone treatment

A case of normoprolactinemic galactorrhea following aneurysmal subarachnoid hemorrhage

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