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Gen Hosp Psychiatry. 2012 Mar-Apr;34(2):209.e1-3. doi: 10.1016/j.genhosppsych.2011.07.004. Epub 2011 Aug 26.

The effect of aripiprazole and quinagolide, a dopamine agonist, in a patient with symptomatic pituitary prolactinoma and chronic psychosis.

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1
Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, 2300RC, Leiden, the Netherlands.

Abstract

BACKGROUND:

Highly potent dopamine D(2) receptor antagonistic antipsychotics may induce hyperprolactinemia. Conversely, drugs for the treatment of prolactinoma may activate dopamine D2 receptors, which can induce or aggravate psychosis. Aripiprazole, as a partial D(2) receptor agonist, may be the drug of choice in patients suffering from both psychosis and prolactinoma.

OBJECTIVE:

We evaluated the effects of aripiprazole on the size of a cystic macroadenoma by magnetic resonance imaging and on prolactin levels in a patient suffering from psychosis and prolactinoma.

METHOD:

This is a case report of a 53-year-old female patient with a chronic psychotic disorder and moderate mental retardation who had developed a prolactinoma that was resected but still had residual adenoma and hyperprolactinemia. Antipsychotic medication was switched from risperidone to aripiprazole before a dopamine agonist was initiated.

RESULTS:

After change in treatment, there were reductions in serum prolactin levels, tumor size and visual field defects. We observed no psychotic decompensation.

CONCLUSION:

The combination of aripiprazole and quinagolide could be considered as an effective treatment in patients suffering from both psychosis and a prolactinoma.

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