Centner Safia, Cooper Felicia, Gurnurkar Shilpa, Hasan Shirin
Medicine, University of Central Florida College of Medicine, Orlando, USA.
Pediatric Endocrinology, Nemours Children's Hospital, Orlando, USA.
Cureus. 2024 May 3;16(5):e59604. doi: 10.7759/cureus.59604. eCollection 2024 May.
Hyperprolactinemia is an endocrinological disorder that might arise from various physiologic or pathologic conditions, as well as from pharmacologic sources. These pharmacologic sources include antidepressants, antipsychotics, and dopamine receptor-blocking agents. Amitriptyline is classified as a tricyclic antidepressant. While it is FDA-approved primarily for the treatment of depression, amitriptyline also demonstrates efficacy in managing various other conditions, such as anxiety, post-traumatic stress disorder, insomnia, chronic and neuropathic pain, and migraine prevention. We present a case of a 10-year-old patient with a history of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and migraine headaches who was incidentally found to have elevated prolactin levels while taking amitriptyline for migraine prophylaxis. While risperidone, an antipsychotic that can be used for ASD management, is commonly known to induce hyperprolactinemia, the association between amitriptyline and elevated prolactin is less frequently described in the literature. This case underscores the necessity for healthcare providers across various specialties to be aware of amitriptyline-induced hyperprolactinemia.
高催乳素血症是一种内分泌紊乱疾病，可能由各种生理或病理状况以及药物因素引起。这些药物因素包括抗抑郁药、抗精神病药和多巴胺受体阻滞剂。阿米替林被归类为三环类抗抑郁药。虽然它主要被美国食品药品监督管理局（FDA）批准用于治疗抑郁症，但阿米替林在治疗其他各种病症方面也显示出疗效，如焦虑症、创伤后应激障碍、失眠、慢性疼痛和神经性疼痛以及预防偏头痛。我们报告一例10岁患者，有自闭症谱系障碍（ASD）、注意力缺陷多动障碍（ADHD）和偏头痛病史，在服用阿米替林预防偏头痛时偶然发现催乳素水平升高。虽然常用于治疗ASD的抗精神病药物利培酮通常会引起高催乳素血症，但文献中较少描述阿米替林与催乳素升高之间的关联。该病例强调了各专业医疗服务提供者了解阿米替林引起的高催乳素血症的必要性。
