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Body Dysmorphic Disorder and Risperidone Abuse: Exploiting Hyperprolactinemia
1Department of Child and Adolescent Psychiatry, University of Health Sciences Türkiye, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye.
Summary
This case report details a teen’s intentional risperidone abuse for cosmetic breast enlargement due to body dysmorphic disorder (BDD). Aripiprazole successfully treated side effects and symptoms, highlighting risks of antipsychotic-induced changes in adolescents.
Area of Science:
- Psychiatry
- Adolescent Medicine
- Pharmacology
Background:
- Body dysmorphic disorder (BDD) is a mental health condition characterized by obsessive preoccupation with perceived flaws in appearance.
- Antipsychotic medications, while effective for certain conditions, can have significant side effects, including hyperprolactinemia.
Observation:
- A 16-year-old female with BDD, tics, and social withdrawal intentionally abused risperidone to induce breast enlargement.
- Risperidone use led to elevated prolactin levels, galactorrhea, and secondary amenorrhea, which the patient perceived as desirable.
- Adjunctive risperidone initially improved BDD and tic symptoms but exacerbated side effects.
Findings:
- Switching to aripiprazole normalized prolactin levels and resolved risperidone-induced side effects.
- Aripiprazole provided sustained symptom control for BDD and tics at 3-month follow-up.
- This is the first reported case of deliberate risperidone abuse for cosmetic hyperprolactinemia in BDD.
Implications:
- Antipsychotic-induced side effects can reinforce BDD pathology, especially in adolescents seeking somatic changes.
- Clinicians must monitor prolactin levels and consider prolactin-sparing agents like aripiprazole in vulnerable populations.
- Adverse drug effects require careful consideration for their potential to perpetuate body image disturbances.
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