Acute psychosis in a woman with a prolactinoma

Changes in dopaminergic activity were inferred in a woman with a known prolactinoma several months prior to an acute psychotic episode. Serum prolactin levels reflected central dopaminergic activity, since both the endocrinologic regulation of prolactinomas and the pathophysiology of acute psychosis have been linked to alterations in dopaminergic activity. Serum prolactin levels fell approximately four months prior to onset of the psychotic episode and thus may have provided a predictive indicator of changing dopamine activity in both the tubero-infundibular and the mesolimbic-mesocortical dopaminergic systems.