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Hyperprolactinaemia: case report. A 29-year-old woman developed hyperprolactinaemia during treatment with risperidone and aripiprazole for probable acute and transient psychotic disorder [routes not stated]. The woman was treated with risperidone 6mg daily for psychotic symptoms of acute and transient psychotic disorder, with a good response. Prior to therapy initiation prolactin level was not measured. After 3 months of risperidone initiation, she complained of amenorrhoea and denied breast tension or galactorrhoea. Her prolactin level was 131.93 ng/mL (normal range: 4.79-23.30 ng/mL). She was not pregnant and her recent MRI scan was normal. Hence, she was assumed to have risperidone induced hyperprolactinaemia. Considering the risk of relapse the risperidone dosage was maintained and aripiprazole 5mg was added to treat hyperprolactinaemia. After 4 weeks, her prolactin level was 126.50 ng/mL. Considering the low response, the risperidone dose was reduced to 4.5 mg/day and the dose of aripiprazole was maintained. After 5 weeks, prolactin level was 131.10 ng/mL. Therefore, cross switch of risperidone to aripiprazole 30 mg/day was performed for 3 months. After 1 month of the switch completion, prolactin level was 21.10 ng/mL. Author comment: "Thus, it was assumed to be a risperidone induced Hyperprolactinaemia (HPRL)." "When risperidone dose was reduced there was an increase in dopaminergic action on overexpressed DRD2, which may have led to aripiprazole functioning as a DRD2 antagonist rather than as a DRD2 agonist, and thus, being responsible for prolactin increase." Dehanov S, et al. P.073 Adjunct aripiprazole failure for risperidone-induced hyperprolactinemia: A dopamine supersensitivity phenomena?. European Neuropsychopharmacology 29 (Suppl. 6): S69-S70, Dec 2019. Available from: 803443858 URL: http://doi.org/10.1016/j.euroneuro.2019.09.133 - Portugal

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Reactions 4 Jan 2020 No. 1785