[Endocrine side effects among psychiatric patients treated with antipsychotics].
The increased serum prolactin is one of the side effects of antipsychotic treatment. The clinical signs of its elevated level are galactorrhea, gynecomastia, breast tenderness and sexual dysfunction. These symptoms can cause poor compliance and relapse of the psychiatric illnesses. The possible clinical interventions are: 1) reduce of the dose of the psychotropic drug and/or addition of a dopamine agonist; 2) switch to another drug. The aim of our study was to evaluate the results of the switch to quetiapine in the cases of elevated prolactin with galactorrhea.


METHODS
Five of our patients (from the January to July in 2005) treated for more than two months with new generation antipsychotics had the symptoms of galactorrhea/breast tenderness. The diagnoses in according to ICD-10 were: schizophrenia and schizoaffective disorder. The differential-diagnostic examination were: physical, neuroimaging and laboratory including prolactin level followed up on the 4th, 8th weeks after the therapeutical intervention.


RESULTS
The galactorrhoea disappeared and prolactin levels normalized after the switching to quetiapine. In the case of bromocriptine addition to previous therapy symptom stopped but the hormone level did not change significantly. There was remission and/or stabilisation of psychotic symptoms with quetiapine.


CONCLUSIONS
The galactorrhea is one of the possible side effects of psychotropic drugs. We presented five patients with this kind of symptoms related to antipsychotic treatment. After the switch to quetiapine the galactorrhea and breast tenderness stopped, the level of prolactin normalized and the psychiatric condition of the patients showed remission. Our data support the benefit of the switch to another new generation drug, first of all to quetiapine, in the cases of galactorrhea and/or elevated prolactin level related to the antipsychotic pharmacotherapy.
Kovács
László
L
MH Központi Honvédkórház, Budapest.
Kovács
Gábor
G
D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000068180:Aripiprazole; D001569:Benzodiazepines / Q000009:adverse effects; D001940:Breast / Q000187:drug effects; D003987:Dibenzothiazepines / Q000008:administration & dosage; D004703:Endocrine System / Q000187:drug effects*; D005260:Female; D005687:Galactorrhea / Q000139:chemically induced*; D006177:Gynecomastia / Q000139:chemically induced*; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010879:Piperazines / Q000009:adverse effects; D011388:Prolactin / Q000097:blood*; D000069348:Quetiapine Fumarate; D015363:Quinolones / Q000009:adverse effects; D012559:Schizophrenia / Q000188:drug therapy; D013469:Sulpiride / Q000009:adverse effects / Q000031:analogs & derivatives
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010879:Piperazines; D015363:Quinolones; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D013469:Sulpiride; D000077582:Amisulpride; D000068180:Aripiprazole; D011388:Prolactin; D000077152:Olanzapine