Meeting abstract

https://doi.org/10.24869/spsih.2026.300

Galactorrhea With Normoprolactinemia in a Patient Treated With Risperidone: A Case Report and Diagnostic and Therapeutic Implications

Matea Katić ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia *
Eliana Burilović ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Tonći Mastelić ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Marjana Milanović ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Andrea Botica ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Davor Lasić ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia

* Corresponding author.

Abstract

Introduction: Neuroendocrine disorders, especially
hyperprolactinemia and consequent galactorrhea,
are among the well‑known and documented
adverse effects of the atypical antipsychotic
risperidone. However, the occurrence of galactorrhea
with normoprolactinemia is much rarer
and raises questions about alternative mechanisms
of onset as well as about further work‑up
and clinical approach. Case report: An 18‑year‑old
female patient was started on risperidone 2 mg
due to psychotic phenomena and aggressive
impulses. Her previous endocrinological status
had been unremarkable. After a short period
following treatment initiation, the patient noticed
breast discharge, and clinical examination confirmed bilateral galactorrhea. The menstrual
cycle was regular. A diagnostic work‑up was
performed for differential diagnostic purposes.
Laboratory findings showed serum prolactin values
within the reference range (209,230 mIU/L).
Thyroid function was normal, as was the breast
ultrasound (BI‑RADS 1). Brain MRI and specialist
examinations excluded organic and endocrine
causes of galactorrhea. Due to the persistence of
symptoms, risperidone was electively discontinued,
after which complete regression of the galactorrhea
was observed. A rechallenge test was
not performed for bioethical reasons. Discussion:
Numerous clinical studies and systematic literature
reviews confirm that antipsychotic‑induced
hyperprolactinemia is a common phenomenon
affecting up to 70% of patients treated for schizophrenia,
whereas the occurrence of normoprolactinemic
galactorrhea is less frequently documented
and limited to sporadic case reports and small
case series, which creates dilemmas in clinical
practice. In this patient, endocrinological causes
and organic breast pathology were excluded
with the available tests, and the literature offers
as possible explanations transient fluctuations in
prolactin secretion, the theory of tissue hypersensitivity,
heterogeneity of the prolactin molecule,
and the role of serotonin. Conclusion: Given the
patient’s age and the availability of alternative
psychopharmacological options, risperidone was
electively discontinued from therapy. The cessation
of galactorrhea strongly implies a role of the
psychotropic medication in this phenomenon. The
case shows that normal prolactin values do not
necessarily exclude a drug‑mediated mechanism
in the development of galactorrhea and highlights
the need for a multidisciplinary approach.

Keywords

galactorrhea; normoprolactinemia; adverse effect; risperidone; psychotropic drugs

Hrčak ID:

352994

URI

https://hrcak.srce.hr/352994

Publication date:

15.6.2026.

Article data in other languages: croatian

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