title: The effect of aripiprazole and quinagolide, a dopamine agonist, in a patient with symptomatic pituitary prolactinoma and chronic psychosis.
abstract: BACKGROUND
  Highly potent dopamine D(2) receptor antagonistic antipsychotics may induce hyperprolactinemia. Conversely, drugs for the treatment of prolactinoma may activate dopamine D2 receptors, which can induce or aggravate psychosis. Aripiprazole, as a partial D(2) receptor agonist, may be the drug of choice in patients suffering from both psychosis and prolactinoma.
  
  
  OBJECTIVE
  We evaluated the effects of aripiprazole on the size of a cystic macroadenoma by magnetic resonance imaging and on prolactin levels in a patient suffering from psychosis and prolactinoma.
  
  
  METHODS
  This is a case report of a 53-year-old female patient with a chronic psychotic disorder and moderate mental retardation who had developed a prolactinoma that was resected but still had residual adenoma and hyperprolactinemia. Antipsychotic medication was switched from risperidone to aripiprazole before a dopamine agonist was initiated.
  
  
  RESULTS
  After change in treatment, there were reductions in serum prolactin levels, tumor size and visual field defects. We observed no psychotic decompensation.
  
  
  CONCLUSIONS
  The combination of aripiprazole and quinagolide could be considered as an effective treatment in patients suffering from both psychosis and a prolactinoma.
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, 2300RC, Leiden, the Netherlands.
authors.forename: Rosalie
authors.initials: R
authors.lastname: Broekhof
authors.forename: Manon J
authors.initials: MJ
authors.lastname: Gosselink
authors.forename: Hanno
authors.initials: H
authors.lastname: Pijl
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
mesh_terms: D000634:Aminoquinolines / Q000494:pharmacology* / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000068180:Aripiprazole; D002908:Chronic Disease; D018491:Dopamine Agonists / Q000494:pharmacology* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D010879:Piperazines / Q000494:pharmacology* / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy*; D011388:Prolactin / Q000097:blood / Q000187:drug effects*; D015175:Prolactinoma / Q000188:drug therapy*; D011618:Psychotic Disorders / Q000150:complications*; D015363:Quinolones / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000634:Aminoquinolines; D014150:Antipsychotic Agents; D018491:Dopamine Agonists; D010879:Piperazines; D015363:Quinolones; C046650:quinagolide; D000068180:Aripiprazole; D011388:Prolactin