Dose Dependent Course of Hyperprolactinemic and Normoprolactinemic Galactorrhea Induced by Venlafaxine

Abstract

Venlafaxine is a serotonergic and noradrenergic reuptake inhibitor which is used for the treatment of depression. We report a case of galactorrhea in a patient with major depressive disorder after starting treatment with venlafaxine. In particular, we discuss the course of hyper and normoprolactinemic galactorrhea. We managed this side effect initially by dose reduction and further by switching to essitalopram. Physicians should be aware of endocrinologic side effects such as galactorrhea during the serotonin and noradrenaline reuptake inhibitor treatment.

Galactorrhea with antidepressants: A case series

“…In the second case, galactorrhea was developed initially with the combination of SSRI and SNRI (venlafaxine 150 mg and fluoxetine 20 mg) with hyperprolactinemia (PRL >200 ng/ml) and later with dosulepin 225 mg with hyperprolactinemia (PRL - 170 ng/ml). Similar cases of fluoxetine-induced[ 3 ] and venlafaxine-induced[ 4 ] galactorrhea with hyperprolactinemia were reported in literature. Only one case of dosulepin (dothiepin)-induced galactorrhea was reported in literature[ 5 ] before index case.…”

Different Endocrine Effects of an Evening Dose of Amitriptyline, Escitalopram, and Placebo in Healthy Participants

“…Symptomatic hyperprolactinemia, a common adverse effect of different antidepressive medications, can result in galactorrhea and erectile dysfunction. 14 , 15) In addition, prolactin has been linked to various different systems, including growth and development, brain and behavior, and immune regulation. 16) …”