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Body Dysmorphic Disorder and Risperidone Abuse: Exploiting Hyperprolactinemia.

Ömer Faruk Bulut1

  • 1Department of Child and Adolescent Psychiatry, University of Health Sciences Türkiye, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye.

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Summary
This summary is machine-generated.

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.

Keywords:
Body dysmorphic disorderDrug abuseHyperprolactinemiaRisperidone

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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.