FREE POSTER ABSTRACT: Major depression with atypical features in a diagnosed case of prolactinoma on treatment with cabergoline: A case report

INTRODUCTION: Prolactinoma is a noncancerous tumor of the pituitary gland and causes the pituitary to make excess prolactin. Dopamine agonists are main stay of treatment. Atypical depression is a subtype of major depression that involves several specific symptoms, including increased appetite or weight gain, sleepiness or excessive sleep, marked fatigue, mood swings strongly reactive to environmental circumstances, and rejection senstivity. CASE REPORT: A 28-year-old female came to OPD with complaints of irritability, sleepiness, marked fatigue and occasional crying spells for 20 days. On history its reveled that she has been diagnosed with prolactinoma 3½ years ago, used cabergoline. After 6 months off medication the prolactin levels raised again (>200 ng/ml) and MRI confirming prolactinoma, she was restarted on cabergoline 0.5mg where she developed mood symptoms after 2 months, treated by decreasing the dose of cabergoline and low dose sertraline for 4 weeks with significant improvement. CONCLUSION: Pituitary adenomas and their treatment can individually and together can present with psychiatric manifestations. So, there is a need for us to evaluate and monitor for signs and symptoms of depression, anxiety and psychosis in pituitary tumors.