A 25 year old woman with a new diagnosis of schizophrenia is started on risperidone. She then presents complaining of galactorrhea.Challenge: What is the mechanism by which risperidone causes galactorrhea?
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Dopamine antagonism "inhibits the inhibition" on prolactin secretion.
risperidone is antidopiminergic, therefore it suppresses dopamine, which normally suppresses prolactin. increased prolactin leads to galactorrhea.
You guys know the basic science way better than I do :)
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Risperidone is an atypical antipsychotic with mixed serotonin-dopamine antagonist activity. Dopamine in the CNS acts as an antagonist to prolactin secretion; thus, the anti-dopaminergic activity leads to increased prolactin and galactorrhea.
Sources: UpToDate; Wikipedia.
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