FRI302 Umar Durrani

Disclosure: U.S. Durrani: None. A. Paracha: None. S. Vasireddy: None. F. Waheed: None. M. Thomure: None. Prolactinomas are tumors of the pituitary gland that induce hyperprolactinemia. Symptoms at presentation can include growth delay, infertility, neurologic deficits and bothersome galactorrhea. Dopamine suppresses prolactin production; therefore, dopamine agonists are first-line treatment for prolactinomas. However, hyperdopaminergia is also associated with psychiatric disorders. The dopamine hypothesis states that cerebral hyperdopaminergia can contribute to symptoms of schizophrenia. Thus, psychiatric disorders are commonly treated with dopamine antagonists. Almost 1 in 8 people in the world have a psychiatric condition. It is almost inevitable that the medical system will have to treat patients with both a psychiatric condition and a prolactinoma; thus, it is essential to identify treatment regimens for these patients. In order to identify potential treatments, we conducted a PubMed literature search focusing on patients with prolactinomas and co-existing psychiatric diagnoses. Our inclusion criteria helped us focus on patients who presented with concurrent prolactinoma and psychiatric condition which were confirmed by brain imaging, serologic prolactin levels, and reports of psychiatric conditions/episodes in their medical history (or chart). Our search yielded 30 studies representing a total of 54 patients with both conditions. We found that four key themes emerged from the literature: 1) discontinuing risperidone in exchange for other atypical antipsychotics such as aripiprazole, olanzapine or ziprasidone, 2) discontinuing thioridazine, thiothixene and remoxipride in exchange for clozapine, 3) dopamine agonist therapy cessation to abate psychiatric symptoms, and 4) surgery and/or radiation after pharmacotherapy. In conclusion, we would recommend focusing on specific antipsychotics (aripiprazole, olanzapine, ziprasidone, or clozapine) while shying away from (risperidone, thioridazine, thiothixene, and remoxipride). We would also recommend ceasing dopamine agonist therapy at least until symptoms improve. If these two methods are not yielding sufficient results, then pursuing surgical options or radiation therapy may be considered. Presentation: Friday, June 16, 2023