Menstrual Resumption after Switching from Risperidone to Quetiapine Treatment: Case Series / 대한정신약물학회지

ABSTRACT

INTRODUCTION: Hyperprolactinemia is associated with gonadal dysfunction, infertility and an increased risk of long-term complications including osteoporosis. METHODS: This is observational study investigating the effectiveness of a switching strategy using quetiapine in 13 women with schizophrenia who were suffering from risperidone-induced amenorrhea. We tried to identify duration of amenorrhea before change of medications into quetiapine, menstrual resumption lead time, baseline serum prolactin level, and the prolactin level right after menstrual resumption. And we used spearman correlation as non-parametric analysis tool. As antipsychotics were changed from risperidone to quetiapine, all participants showed lowered prolactin level and resumed menstruation. RESULTS: Prolactin levels were changed from baseline 98.98+/-56.66 ng/ml to 14.76+/-19.83 ng/ml right after menstrual resumption. The average time taken for resuming the menstruation was 26.31+/-12.22 days. There was a significant correlation between the average time taken for menstruation resumption and baseline prolactin level, but we couldn't find a correlation between baseline prolactin levels and duration of amenorrhea, and between changed prolactin levels and duration of amenorrhea. 3 of 13 patients underwent aggravation of psychiatric symptoms after risperidone was changed into quetiapine. CONCLUSION: Quetiapine was useful for the purpose of menstrual resumption. However, clinicians need to consider the relative merits of changing the antipsychotic drugs in patients who are already symptomatically stable but experiencing the menstrual irregularities.