Neuroleptics and Prolactin: Mechanism

Neuroleptic medications can produce hyperprolactinemia even at very low doses and are the most common cause of galactorrhea in psychiatric patients.

HOW???

Hyperprolactinemia with neuroleptic use is secondary to the blockade of dopamine receptors with these drugs. (Dopamine normally inhibits prolactin, and with dopamine’s blockade, hyperprolactinemia can result.) Amenorrhea and galactorrhea are the main symptoms of hyperprolactinemia in women, and impotence is the main symptom in men, although men can also develop gynecomastia and galactorrhea.

NOTE: Other causes of hyperprolactinemia include severe systemic illness such as cirrhosis or renal failure, pituitary tumors, idiopathic sources, and pregnancy.

REFERENCES

  1. Kleinberg DL, Davis JM, de Coster R, Van Baelen B, Brecher M. Prolactin levels and adverse events in patients treated with risperidone. J Clin Psychopharmacol 1999;19:57-61
  2. Wudarsky M, Nicolson R, Hamburger SD, Spechler L, Gochman P, Bedwell J, Lenane MC, Rapoport JL. Elevated prolactin in pediatric patients on typical and atypical antipsychotics. J Child Adolesc Psychopharmacol 1999;9:239-45
Get Medical Pearls directly to your inbox every week!
Weekly posts with high yield medical knowledge, directly to your mailbox!
Dr. C Humphreys

Internal Medicine

Recent Posts

Mechanism of Mixed Apnea

Mixed apneas are characterized by absent respiratory effort and airflow in the first section of…

8 months ago

How Does Hypothyroidism Cause Hypoventilation?

Although rare, the differential diagnosis of hypoventilation and hypercapnia respiratory failure includes hypothyroidism. It is…

8 months ago

Why is Pro-BNP/ BNP lower in Obesity?

B-type natriuretic peptide (BNP) is a hormone created in response to cardiac wall stretch due…

1 year ago

What is Peribronchovascular Distribution on CT imaging?

A common finding described on computed tomography (CT) imaging. A disease with a peribronchovascular distribution…

2 years ago

Trapped Lung vs. Lung Entrapment

Though often used synonymously; Trapped Lung and Lung Entrapment technically describe separate entities along the…

2 years ago

Cause of Pericardial Effusion in Pulmonary Hypertension: Pathogenesis

It is not clearly understood why patients with pulmonary hypertension (PH) develop pericardial effusions. However,…

2 years ago

This website uses cookies.