Improvement of risperidone-induced hyperprolactinemia with the addition of aripiprazole: Case report

Objective: Hyperprolactinemia is an important side effect of antipsychotic treatment. All typical antipsychotics and some atypical antipsychotics such as risperidone and amisulpiride have been shown to cause marked elevation in serum prolactin levels, whereas most other atypical antipsychotics such as quetiapine, olanzapine, clozapine, ziprasidone, and aripiprazole appear to have little or no effect on serum prolactin levels. Hyperprolactinemia can lead to gynecomastia, galactorrhea, sexual dysfunction, infertility, oligomenorrhea, and amenorrhea. It also reduces the bone mineral density and contributes to osteoporosis in the long term. These important side effects cause patients in remission not to continue treatment.

Case: We report two clinical cases of risperidone-induced hyperprolactinemia and amenorrhea, who with treatment by the partial dopamine agonist aripiprazole, showed prolactin normalization.

Conclusion: Addition of aripiprazole to treatment may be considered as a first option in hyperprolactinemia cases with significant improvement in psychotic symptoms.