SSRI-Induced Galactorrhea in Adolescents

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.