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Treatment in risperidone-induced amenorrhoea.

Bun-Hee Lee1, Chang-Su Han, Kye-Hyun Kim

  • 1Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.

International Journal of Psychiatry in Clinical Practice
|June 20, 2014
PubMed
Summary

Stopping risperidone or switching to a prolactin-sparing antipsychotic effectively resolves amenorrhea. Dose reduction is rarely effective, risking continued amenorrhea or psychosis relapse.

Keywords:
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Area of Science:

  • Endocrinology
  • Psychiatry
  • Pharmacology

Background:

  • Risperidone, an antipsychotic, can cause hyperprolactinemia leading to amenorrhea.
  • Amenorrhea associated with risperidone requires management strategies.

Purpose of the Study:

  • To determine optimal interventions for resolving risperidone-induced amenorrhea.
  • To evaluate the efficacy of dose reduction versus switching antipsychotics.

Main Methods:

  • Observational study of 16 female outpatients experiencing amenorrhea on risperidone.
  • Monitoring of serum prolactin levels, menstrual cycles, and mental status for 6 months.
  • Interventions included risperidone dose reduction or switching to olanzapine or quetiapine.

Main Results:

  • Hyperprolactinemia was present in 14 of 16 patients.
  • Complete amenorrhea resolution occurred in all patients who switched antipsychotics.
  • Amenorrhea resolved in 2 patients who discontinued risperidone and 3 on reduced doses (≤3 mg/day).

Conclusions:

  • Discontinuation or switching to prolactin-sparing agents effectively resolves risperidone-associated amenorrhea.
  • Risperidone dose reduction is generally ineffective, with risks of persistent amenorrhea or psychosis relapse.