title: Hypogonadism due to hyperprolactinemia and subsequent first episode of psychosis.
abstract: BACKGROUND
  Hyperprolactinemia causes hypogonadotrophic hypogonadism. Hyperprolactinemia can be pre-existing in some patients with schizophrenia. Dopamine is the most important prolactin-inhibiting factor, and dopaminergic hyperactivity has been implicated in the pathophysiology of psychosis.
  
  
  OBJECTIVE
  Since dopamine is a prolactin-inhibiting factor and dopamine imbalanced has been implicated in the pathophysiology of psychotic disorders, we investigated the probable relationship between hyperprolactinemia and the development of psychotic symptoms, in a patient with hypogonadism due to hyperprolactnemia and subsequent first episode of psychosis. Since dopamine is a prolactin-inhibiting factor and dopamine imbalance has been implicated in the pathophysiology of psychotic disorders, we investigated the probable relationship between hyperprolactinemia and the development of psychotic symptoms.
  
  
  METHODS
  We present the case of a patient with hypogonadism secondary to chronic, untreated hyperprolactinemia who developed acute psychotic symptoms.
  
  
  RESULTS
  Psychotic symptoms resolved soon after treatment with aripiprazole in conjunction with cabergoline, with a concomitant decrease in serum prolactin level.
  
  
  CONCLUSIONS
  This is an interesting case illustrating a complicated relationship among hypogonadism secondary to a prolactinoma and dopamine and psychosis.
authors.affiliation: 2nd Department of Psychiatry, Medical School, University of Athens, Athens, Greece.
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Tsigkaropoulou
authors.forename: Melpomeni
authors.initials: M
authors.lastname: Peppa
authors.forename: Christina
authors.initials: C
authors.lastname: Zompola
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Rizos
authors.forename: Ioanna
authors.initials: I
authors.lastname: Xelioti
authors.forename: Sofia
authors.initials: S
authors.lastname: Chatziioannou
authors.forename: Anastasia
authors.initials: A
authors.lastname: Filippopoulou
authors.forename: Lefteris
authors.initials: L
authors.lastname: Lykouras
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole; D000077465:Cabergoline; D004873:Ergolines / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications*; D007006:Hypogonadism / Q000209:etiology*; D008297:Male; D009767:Obesity, Morbid / Q000150:complications; D010879:Piperazines / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000150:complications*; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000150:complications*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000209:etiology*; D015363:Quinolones / Q000627:therapeutic use; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy
chemical_list: D014150:Antipsychotic Agents; D004873:Ergolines; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole; D011388:Prolactin; D000077465:Cabergoline