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SSRI-Induced Galactorrhea in Adolescents.

Setenay Adıgüzel1, Hesham M Hamoda2

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Journal of Child and Adolescent Psychopharmacology
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Selective serotonin reuptake inhibitors (SSRIs) can cause galactorrhea (inappropriate milk secretion) in adolescents, even with normal prolactin levels. This rare side effect typically resolves with treatment adjustment.

Keywords:
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Area of Science:

  • Pediatric Endocrinology
  • Neuroendocrinology
  • Adolescent Medicine

Background:

  • Selective serotonin reuptuptake inhibitors (SSRIs) are widely prescribed for children and adolescents.
  • Neuroendocrine side effects, including hyperprolactinemia and galactorrhea, are rare but documented SSRI adverse effects.
  • Galactorrhea, or inappropriate milk secretion, has been infrequently reported in adolescents compared to adults.

Purpose of the Study:

  • To investigate the occurrence and characteristics of SSRI-associated galactorrhea in adolescents.
  • To raise clinical awareness of this uncommon adverse effect in pediatric populations.

Main Methods:

  • A systematic literature search of PubMed and Embase was performed.
  • Case reports and series of patients aged 18 years or younger experiencing SSRI-associated galactorrhea were identified.
  • Seven adolescent female cases were included.

Main Results:

  • SSRIs implicated included citalopram, escitalopram, fluoxetine, sertraline, and paroxetine.
  • Onset of galactorrhea varied from days to weeks after SSRI initiation or dose increase.
  • Galactorrhea resolved or improved upon SSRI dose reduction, discontinuation, or switching, with some cases recurring upon re-exposure to serotonergic agents.

Conclusions:

  • SSRI-induced galactorrhea and hyperprolactinemia are uncommon but possible in adolescents.
  • Clinicians should consider galactorrhea as a potential SSRI side effect, even with normal or mildly elevated prolactin levels.
  • Further research is necessary to understand the prevalence, risk factors, and mechanisms of SSRI-induced galactorrhea in adolescents.