Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, 2300RC, Leiden, the Netherlands.
Gen Hosp Psychiatry. 2012 Mar-Apr;34(2):209.e1-3. doi: 10.1016/j.genhosppsych.2011.07.004. Epub 2011 Aug 26.
Highly potent dopamine D(2) receptor antagonistic antipsychotics may induce hyperprolactinemia. Conversely, drugs for the treatment of prolactinoma may activate dopamine D2 receptors, which can induce or aggravate psychosis. Aripiprazole, as a partial D(2) receptor agonist, may be the drug of choice in patients suffering from both psychosis and prolactinoma.
We evaluated the effects of aripiprazole on the size of a cystic macroadenoma by magnetic resonance imaging and on prolactin levels in a patient suffering from psychosis and prolactinoma.
This is a case report of a 53-year-old female patient with a chronic psychotic disorder and moderate mental retardation who had developed a prolactinoma that was resected but still had residual adenoma and hyperprolactinemia. Antipsychotic medication was switched from risperidone to aripiprazole before a dopamine agonist was initiated.
After change in treatment, there were reductions in serum prolactin levels, tumor size and visual field defects. We observed no psychotic decompensation.
The combination of aripiprazole and quinagolide could be considered as an effective treatment in patients suffering from both psychosis and a prolactinoma.
高选择性多巴胺 D2 受体拮抗剂类抗精神病药物可能会导致高催乳素血症。相反，用于治疗催乳素瘤的药物可能会激活多巴胺 D2 受体，从而引发或加重精神病。阿立哌唑作为一种部分 D2 受体激动剂，可能是同时患有精神病和催乳素瘤患者的首选药物。
我们通过磁共振成像评估阿立哌唑对患有精神病和催乳素瘤的患者的囊性大腺瘤大小和催乳素水平的影响。
这是一例 53 岁女性慢性精神病患者的病例报告，该患者患有催乳素瘤，已接受手术切除，但仍有残余腺瘤和高催乳素血症。在开始使用多巴胺激动剂之前，将抗精神病药物从利培酮转换为阿立哌唑。
治疗改变后，血清催乳素水平、肿瘤大小和视野缺损均有所降低。我们未观察到精神病恶化。
阿立哌唑联合喹高利特可被视为同时患有精神病和催乳素瘤患者的有效治疗方法。
