Effects of Rivastigmine in a Case of Residual Schizophrenia

Abstract

Aripiprazole is a new-generation atypical antipsychotic agent. It is a partial agonist at the dopamine D 2 and serotonin 1A (5-HT 1A) receptor sites; it is an antagonist at the 5-HT 2 receptor site (1). Data from the aripiprazole clinical trials suggest that the drug may reduce serum prolactin levels (2). However, we have observed a case of raised serum prolactin and galactorrhea in association with aripiprazole. To the best of our knowledge, this is the first case of aripiprazole-induced galactorrhea in world literature. Case Report Mrs S, aged 36 years, presented with a 2-month history of suspiciousness, withdrawal, and neglect of personal care. She fulfilled DSM-IV criteria for schizophreniform disorder. She was drug-naive for the episode, and was prescribed aripiprazole in a dosage that was titrated from 10 mg daily to 15 mg daily over a period of 2 weeks. At week 3 of aripriprazole therapy, she developed tremor, rigidity, salivation, and bradykinesia, along with simultaneous breast tenderness and a milky discharge from the nipples. Her serum prolactin was found to be elevated to 27 ng/mL (normal range, 1.5 to 19.0 ng/mL). All other investigations, including thyroid profile and brain CT scan, were normal.