ergoline and Psychotic-Disorders

Topics: Adult; Antipsychotic Agents; Cabergoline; Cesarean Section; Dopamine Agonists; Ergolines; Female; Hallucinations; Humans; Lactation; Postoperative Complications; Pregnancy; Pregnancy Complications; Pregnancy, Twin; Psychomotor Agitation; Psychotic Disorders; Puerperal Disorders; Risperidone; Sleep Initiation and Maintenance Disorders

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.. 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.. We present the case of a patient with hypogonadism secondary to chronic, untreated hyperprolactinemia who developed acute psychotic symptoms.. Psychotic symptoms resolved soon after treatment with aripiprazole in conjunction with cabergoline, with a concomitant decrease in serum prolactin level.. This is an interesting case illustrating a complicated relationship among hypogonadism secondary to a prolactinoma and dopamine and psychosis.

Topics: Adult; Antipsychotic Agents; Aripiprazole; Cabergoline; Ergolines; Humans; Hyperprolactinemia; Hypogonadism; Male; Obesity, Morbid; Piperazines; Pituitary Neoplasms; Prolactin; Prolactinoma; Psychotic Disorders; Quinolones; Schizophrenia

Topics: Cabergoline; Depression, Postpartum; Dopamine Agonists; Ergolines; Female; Humans; Lactation; Psychotic Disorders

Risperidone is a novel antipsychotic agent that blocks both dopaminergic and serotonergic receptors. In several reports, clinically significant hyperprolactinemia has been reported in patients on this agent. However, the optimal management of risperidone-induced hyperprolactinemia has not been clarified. We reviewed the records of 5 patients with psychotic disorders who were evaluated for risperidone-induced hyperprolactinemia. There were 4 females and 1 male patient, aged 30-45 yr. All patients had significant hyperprolactinemia, with prolactin (PRL) levels ranging from 65.5 to 209 microg/l. All but 1 of these patients had manifestations of hypogonadism. In these 4 patients, risperidone therapy was continued and the dopamine agonists bromocriptine or cabergoline were added. In 3 out of 4 patients, such additional therapy reduced the PRL level and alleviated hypogonadism. None of the patients treated with these agents had a worsening of psychosis. We conclude that risperidone can cause clinically significant hyperprolactinemia in patients treated with this drug. If risperidone therapy must be continued in such patients, addition of the dopamine agonists bromocriptine or cabergoline may successfully alleviate hyperprolactinemia and the associated manifestations without worsening psychotic symptoms.

Topics: Adult; Antipsychotic Agents; Bromocriptine; Cabergoline; Dopamine Agonists; Ergolines; Female; Humans; Hyperprolactinemia; Hypogonadism; Male; Middle Aged; Prolactin; Psychotic Disorders; Risperidone