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Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania
A previously healthy 32-year-old woman developed cyclical mood swings after being prescribed cabergoline for a pituitary microprolactinoma. These mood swings persisted for over 2 years, at which point she developed an acute manic episode with psychotic features and was admitted to a psychiatry unit....
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bioscientifica Ltd
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650831/ https://www.ncbi.nlm.nih.gov/pubmed/26587235 http://dx.doi.org/10.1530/EDM-15-0100 |
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author | Burback, Lisa |
author_facet | Burback, Lisa |
author_sort | Burback, Lisa |
collection | PubMed |
description | A previously healthy 32-year-old woman developed cyclical mood swings after being prescribed cabergoline for a pituitary microprolactinoma. These mood swings persisted for over 2 years, at which point she developed an acute manic episode with psychotic features and was admitted to a psychiatry unit. Cabergoline was discontinued and replaced with aripiprazole 10 mg/day. Her manic episode quickly resolved, and she was discharged within 6 days of admission. The aripiprazole suppressed her prolactin levels for over 18 months of follow-up, even after the dose was lowered to 2 mg/day. There was no significant change in tumor size over 15 months and treatment was well tolerated. However, after 9 months of taking 2 mg aripiprazole, she developed brief manic symptoms, and the dose was returned to 10 mg daily, with good effect. LEARNING POINTS: Dopamine agonists such as cabergoline, which are a standard treatment for microprolactinomas, can have serious adverse effects such as psychosis or valvular heart disease. Aripiprazole is a well-tolerated atypical antipsychotic that, unlike other antipsychotics, is a partial dopamine agonist capable of suppressing prolactin levels. Adjunctive, low-dose aripiprazole has been utilized to reverse risperidone-induced hyperprolactinemia. This case report demonstrates how aripiprazole monotherapy, in doses ranging from 2 to 10 mg/day, was effective in suppressing prolactin in a woman with a microprolactinoma who developed psychiatric side effects from cabergoline. |
format | Online Article Text |
id | pubmed-4650831 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-46508312015-11-19 Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania Burback, Lisa Endocrinol Diabetes Metab Case Rep Novel Treatment A previously healthy 32-year-old woman developed cyclical mood swings after being prescribed cabergoline for a pituitary microprolactinoma. These mood swings persisted for over 2 years, at which point she developed an acute manic episode with psychotic features and was admitted to a psychiatry unit. Cabergoline was discontinued and replaced with aripiprazole 10 mg/day. Her manic episode quickly resolved, and she was discharged within 6 days of admission. The aripiprazole suppressed her prolactin levels for over 18 months of follow-up, even after the dose was lowered to 2 mg/day. There was no significant change in tumor size over 15 months and treatment was well tolerated. However, after 9 months of taking 2 mg aripiprazole, she developed brief manic symptoms, and the dose was returned to 10 mg daily, with good effect. LEARNING POINTS: Dopamine agonists such as cabergoline, which are a standard treatment for microprolactinomas, can have serious adverse effects such as psychosis or valvular heart disease. Aripiprazole is a well-tolerated atypical antipsychotic that, unlike other antipsychotics, is a partial dopamine agonist capable of suppressing prolactin levels. Adjunctive, low-dose aripiprazole has been utilized to reverse risperidone-induced hyperprolactinemia. This case report demonstrates how aripiprazole monotherapy, in doses ranging from 2 to 10 mg/day, was effective in suppressing prolactin in a woman with a microprolactinoma who developed psychiatric side effects from cabergoline. Bioscientifica Ltd 2015-10-06 2015 /pmc/articles/PMC4650831/ /pubmed/26587235 http://dx.doi.org/10.1530/EDM-15-0100 Text en © 2015 The authors This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en_GB) . |
spellingShingle | Novel Treatment Burback, Lisa Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania |
title | Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania |
title_full | Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania |
title_fullStr | Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania |
title_full_unstemmed | Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania |
title_short | Management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania |
title_sort | management of a microprolactinoma with aripiprazole in a woman with cabergoline-induced mania |
topic | Novel Treatment |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650831/ https://www.ncbi.nlm.nih.gov/pubmed/26587235 http://dx.doi.org/10.1530/EDM-15-0100 |
work_keys_str_mv | AT burbacklisa managementofamicroprolactinomawitharipiprazoleinawomanwithcabergolineinducedmania |