Transient normoprolactinemic galactorrhea induced by fluoxetine

Abstract

Hormonal side effects of antidepressants are infrequent. Galactorrhea is rarely reported among antidepressant related side effects. Antidepressants can directly stimu­late postsynaptic 5- Hydroxytryptamine (5-HT) receptors in the hypothalamus or indirectly inhibit the tuberoinfun­dibular dopaminergic neurons through 5-HT, which may increase prolactin levels and later cause galactorrhea. However, galactorrhea may develop despite normal pro­lactin levels during antidepressant treatment. We present a case of normoprolactinemic galactorrhea in a woman, related with fluoxetine treatment. This report highlights the presence of unidentified mechanisms of selective serotonin reuptake inhibitor induced galactorrhea. J Clin Exp Invest 2013; 4 (1): 105-106

Keywords

• Fluoxetine, galactorrhea, side effect

Fluoksetine bağlı, geçici normoprolaktinemik galaktore

Abstract

Antidepresanlara bağlı hormonal yan etkiler sık görülme­mektedir. Galaktore, antidepresanlara bağlı yan etkiler arasında nadiren bildirilmiştir. Antidepresanlar, hipotala­mustaki postsinaptik 5-Hidroksitriptamin (5-HT) reseptör­lerini doğrudan uyararak veya tuberoinfindibuler dopami­nerjik nöronları 5-HT üzerinden dolaylı olarak inhibe ede­rek prolaktin seviyelerinde artışa ve sonuçta galaktoreye neden olabilirler. Ancak antidepresan tedavisi sırasında normal prolaktin seviyelerine rağmen galaktore gelişebilir. Bu çalışmada fluoksetin tedavisi ile ilişkili normoprolakti­nemik galaktore gelişen bir kadın olgu sunulacaktır. Bu olgu sunumu ile selektif serotonin gerialım inhibitörlerine bağlı galaktorenin tanımlanmamış mekanizmalarının var­lığı üzerine vurgu yapılacaktır.

Keywords

• Fluoksetin, galaktore, yan etki

References

1. Bostwick JR, Guthrie SK, Ellingrod VL. Antipsychot- ic-induced hyperprolactinemia. Pharmacotherapy 2009;29 :64-73.
2. Anand VS. Clomipramine-induced galactorrhea and amenorrhea. Br J Psychiatry 1985;147:87-88.
3. Gülsün M, Evrensel A, Verim S. Galactorrhea during escitalopram treatment: A case report Bulletin of Clical Psychopharmacology 2006;16:39-41.
4. Nicholas L, Dawkins K, Golden RN. Psychoneuroen- docrinology of depression. Prolactin. Psychiatr Clin North Am 1998;21:341-358.
5. Arya DK. Extrapyramidal symptoms with selec- tive serotonin reuptake inhibitors. Br J Psychiatry 1994;165:728-733.
6. Gulsun M, Algul A, Semiz UB, et al. A case with eupro- lactinemic galactorrhea induced by escitalopram. Int J Psychiatry Med 2007;37:275-278.
7. Belli H, Vardar MK, Yesilyurt S, et al. Citalopram related euprolactinaemic galactorrhoea: a case report. West Indian Med J 2010;59:100-101.
8. Peterson MC. Reversible galactorrhea and prolactin elevation related to fluoxetine use. Mayo Clin Proc 2001;76:215-216.

9. Meltzer H, Bastani B, Jayathilake K, Maes M. Fluox- etine, but not tricyclic antidepressants, potentiates the 5-hydroxytryptophan-mediated increase in plasma cortisol and prolactin secretion in subjects with ma- jor depression or with obsessive-compulsive disorder. Neuropsychopharmacology 1997;17:1-11.
10. Haefliger T, Bonsack C. Atypical antipsychotics and sexual dysfunction: five case-reports associated with risperidone. Encephale 2006;32:97-105.