Risperidone induced amenorrhea and galactorrhea in a case of an adolescent patient

Abstract

Galactorrhea and amenorrhea are known risks of risperidone, given risperidone’s blockade of dopamine D2 receptors and subsequent risk of prolactin elevation, and this paper presents the case of an adolescent female patient who developed reversible amenorrhea and galactorrhea after being treated with risperidone 0.25 mg twice a day for three months. Her prolactin levels and pituitary MRI were normal and the patient’s menstrual cycles returned to normal after risperidone was discontinued. This case is the sole example found in our literature search regarding an adolescent patient, which raises the unusual and unpredictable responses to psychotropic medications in this population, as most clinical trials are performed with adult patients. This patient was also previously treated with sertraline, which raises the question of a possible drug interaction. Sertraline is known to increase risperidone levels by inhibiting hepatic metabolism, but this does not explain the unusual side effect experiences by this patient: amenorrhea and galactorrhea in the setting of normal prolactin levels.

Keywords

• prolactin
• risperidone
• dopamine
• amenorrhea
• galactorrhea