title: Gynecomastia with sulpiride.
abstract: Neuroleptic agents have been associated with gynecomastia, but evidence for a causal link is insufficient. We describe a case of unilateral gynecomastia without galactorrhea in a 38-year-old man during sulpiride treatment for generalized anxiety disorder. The patient had been treated with sulpiride (100 mg/day) for about 5 months by a primary care physician. In this patient, no specific endocrine alterations were found, except for a marked increase in prolactin (PRL) level and slight decrease in testosterone (T)/estradiol (E2) ratio. Drug withdrawal led to a reduction of the lump. Sulpiride is a substituted benzamide with selective dopaminergic blocking activity. From the marked increase in PRL level and the slight decrease in T/E2 ratio observed during sulpiride therapy, it is proposed that sulpiride may induce gynecomastia by inhibiting hypothalamic-pituitary function directly, and/or indirectly through hyperPRLemia.
authors.affiliation: Department of Neuropsychiatry, The University of Tokushima School of Medicine, Tokushima, Japan. kaneday@clin.med.tokushima-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Kaneda
authors.forename: A
authors.initials: A
authors.lastname: Fujii
mesh_terms: D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy; D004958:Estradiol / Q000097:blood; D006177:Gynecomastia / Q000139:chemically induced*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D008297:Male; D011388:Prolactin / Q000097:blood; D013469:Sulpiride / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D013739:Testosterone / Q000097:blood
chemical_list: D014150:Antipsychotic Agents; D013739:Testosterone; D004958:Estradiol; D013469:Sulpiride; D011388:Prolactin