Amenorrhea risperidone

All conventional antipsychotic medications and risperidone may cause hyperprolactinemia. Side effects mediated, at least in part, by hyperprolactinemia include gynecomastia, galactorrhea, amenorrhea, and decreased libido. Thioridazine may cause painful retrograde ejaculation. 

A 35-year-old woman developed hyperprolactinemia, amenorrhea, and galactorrhea after taking risperidone for 2 months the effects persisted after she switched to olanzapine, mean dose 2.5 mg/day (854). 

A 34-year-old woman, who developed amenorrhea while taking risperidone, regained her normal menstrual pattern along with a marked fall in serum prolactin concentration 8 weeks after being switched to olanzapine, whereas amantadine had failed to normalize the menses and had apparently reactivated the psychotic symptoms (856). 

The relation of prolactin concentrations and certain adverse events has been explored by using data from two large randomized, double-blind studies (n = 2725 813 women, 1912 men) (1018). Both risperidone and haloperidol produced dose-related increases in plasma prolactin concentrations in men and women, but they were not correlated with adverse events such as amenorrhea, galactorrhea, or reduced libido in women or with erectile dysfunction, ejaculatory dysfunction, gynecomastia, or reduced libido in men. Nevertheless, in five patients risperidone (1-8 mg/day) caused amenorrhea in association with raised serum prolactin concentrations (mean 122 ng/ml, range 61-230 ng/ml reference range 2.7-20 ng/ml) (1019). 

Furthermore, risperidone-induced galactorrhea associated with a raised prolactin has been reported (1020,1021), as have amenorrhea and sexual dysfunction (1022). 

Amenorrhea presumed to have been induced by risperidone has been successfully treated with Shakuyaku-kanzo-to, a Japanese herbal medicine that contains Peoniae radix and Glycyrrhizae radix (1038). 

Yamada K, Kanba S, Yagi G, Asai M. Herbal medicine (Shakuyaku-kanzo-to) in the treatment of risperidone-induced amenorrhea. J Clin Psychopharmacol 1999 19(4) 380-1. 

Amenorrhea and infertility were consequences of the effects of typical neuroleptic drugs and of risperidone. Clinicians should be aware that patients changed from these agents to drugs like olanzapine, quetiapine, or clozapine are therefore at risk of pregnancy (6). 

Risperidone has also been used in combination with topiramate in a Spanish multicenter study in 58 patients (28 men and 30 women mean age 41 years) with bipolar I disorder, with manic but not mixed episodes (20). Risperidone (mean dose 2.7 mg/day) and topiramate (mean dose 236 mg/day) were started with a maximum 48-hour time difference risperidone was used for acute manic symptoms and topiramate for longer-term stabilization and prevention of relapse. The incidence of any adverse event was 64%, mostly somnolence, paresthesia, dizziness, tremor, weight loss (n = 27 mean change -1.1 kg), extrapyramidal disorders, gastrointestinal effects, and cognitive disturbances. One patient developed tardive dyskinesia during the study and there were five dropouts because of adverse effects adverse effects that required withdrawal of risperidone but not topiramate were amenorrhea (n = 3) and sexual dysfunction (n = 1). 

Risperidone-induced galactorrhea associated with a raised prolactin has been reported (149,150,151), as have amenorrhea and sexual dysfunction (9). It is suggested that this condition can occur after many weeks of risperidone treatment, with small dosages (2-4 mg/day), and at times even after drug withdrawal. 

The risk of prolactinoma in patients taking risperidone and other neuroleptic drugs, accompanied by hyperprolactinemia, amenorrhea, and galactorrhea has been discussed in the light of a case of hyperprolactinemia (160). 

Amenorrhea presumed to have been induced by risperidone has been successfully treated with... 

In the second study, which lasted 2 years, long-acting injectable risperidone (n = 50) was compared with oral risperidone (n = 47) and haloperidol (n = 47) [130. Prolactin-related adverse events occurred in four of those who received injectable risperidone galactorrhea in one amenorrhea... 

In 50 patients with newly diagnosed schizophrenia (mean age 25 years) who were treated with injectable risperidone 25-50 mg every 2 weeks for 2 years [132 ], prolactin concentrations increased in 18 patients, four of whom reported possible prolactin-related adverse events (amenorrhea in one galactorrhea in one amenorrhea and galactorrhea in one amenorrhea and delayed menses in one). Mean increase in body mass index was 4.8 kg/m 10 subjects required anticholinergic medication, and one developed persistent dyskinesia. 

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