Meeting abstract

GALACTORRHEA - SIDE EFFECT OF RISPERIDONE IN COMBINATION WITH DEPAKINE CHRONO IN A PATIENT WITH BIPOLAR DISORDER

Marija Vučić Peitl ; Psychiatric Clinic of KBC Rijeka, Cambijerijeva 17/7, 51000 Rijeka, Croatia
Vjekoslav Peitl ; Psychiatric Clinic of KBC Rijeka, Cambijerijeva 17/7, 51000 Rijeka, Croatia
Tanja Grahovac ; Psychiatric Clinic of KBC Rijeka, Cambijerijeva 17/7, 51000 Rijeka, Croatia
Eduard Pavlović ; Psychiatric Clinic of KBC Rijeka, Cambijerijeva 17/7, 51000 Rijeka, Croatia

Abstract

Risperidone, as all atypical antipsychotics, can cause hyperprolactinemia which can in turn lead to galactorrhea. Mood
stabilizers, one of which is valproic acid and its derivate „Depakine Chrono“, are rarely linked with symptomatic
hyperprolactinemia and do not alter prolactin concentrations.
This case is based around a patient suffering from a bipolar disorder that has been psychiatrically treated in an outpatient clinic
during four years. Bipolar disorder treatment was started with carbamazepine, but later it was discontinued due to adverse events
and extreme increase of liver transaminases. Treatment was continued with introduction of lithium, but the patient stated that she
could not tolerate it. Subsequently, her endocrinologist advised for lithium discontinuation due to very severe osteoporosis. At the
beginning of 2009, lithium was discontinued and Depakine Chrono was introduced. Due to patient’s psychotic decompensation it
was necessary to introduce risperidone into treatment and soon afterwards her psychotic symptoms settled. After several months of
treatment her mood lowered, she began to feel sedated, psychomotorically retarded and that lead to dose lowering of Depakine
Chrono and risperidone, at which point galactorrhea as a serious adverse event occurred.
Occurrence of galactorrhea at lower risperidone doses in this case might be partially explained by recent studies that showed
that lower doses of risperidone can also improve psychic state, but could also cause adverse events.
Although galactorrhea, as a direct consequence of hyperprolactinemia caused by risperidone has mainly been researched with
higher doses of this atypical antipsychotic, we have to keep in mind that lower doses could also cause serious adverse events.

Keywords

galactorrhea; risperidone; Depakine chrono; bipolar disorder

Hrčak ID:

48666

URI

https://hrcak.srce.hr/48666

Publication date:

10.2.2010.

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