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q15 - guest1
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09-22-2007, 05:03 PM
A 28-year-old woman presents with amenorrhea and galactorrhea, after beginning a new medication recently. Which of the following medications is most likely responsible for this patients symptoms
A. Haloperidol B. Lisinopril C. Fluoxetine D. Amitriptyline E. Buspirone
09-22-2007, 05:10 PM
The answer is: A
Medications are important in the differential diagnosis of hyperprolactinemia. Prolactin release is under inhibitory control primarily from dopaminergic neurons in the hypothalamus. Dopamine attaches to D2 receptors on lactotrophs to reduce prolactin release. Dopamine antagonists reduce the inhibition. A common drug that causes increased prolactin with possible amenorrhea and galactorrhea is haloperidol, a dopamine antagonist. Lisinopril has no effect on prolactin levels. The antidepressants fluoxetine and amitriptyline and anxiolytic bupropion may cause small changes in prolactin levels but rarely enough to cause a clinical syndrome.
09-22-2007, 05:11 PM
change again, haloperidol because it interfere with dopamin action (D2 receptor antagonist)
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