Diagnosis and Treatment > Medication > Aripiprazole
You are looking at 1 - 2 of 2 items
Search for other papers by Durgesh Prasad Chaudhary in
Google Scholar
PubMed
Search for other papers by Tshristi Rijal in
Google Scholar
PubMed
Search for other papers by Kunal Kishor Jha in
Google Scholar
PubMed
Search for other papers by Harpreet Saluja in
Google Scholar
PubMed
Summary
Combined pituitary hormonal deficiency (CPHD) is a rare disease that results from mutations in genes coding for transcription factors that regulate the differentiation of pituitary cells. PROP1 gene mutations are one of the etiological diagnoses of congenital panhypopituitarism, however symptoms vary depending on phenotypic expression. We present a case of psychosis in a 36-year-old female with congenital panhypopituitarism who presented with paranoia, flat affect and ideas of reference without a delirious mental state, which resolved with hormone replacement and antipsychotics. Further evaluation revealed that she had a homozygous mutation of PROP1 gene. In summary, compliance with hormonal therapy for patients with hypopituitarism appears to be effective for the prevention and treatment of acute psychosis symptoms.
Learning points:
-
Patients with PROP1 gene mutation may present with psychosis with no impairment in orientation and memory.
-
There is currently inadequate literature on this topic, and further study on the possible mechanisms of psychosis as a result of endocrine disturbance is required.
-
Compliance with hormonal therapy for patients with hypopituitarism appears to be effective for prevention and treatment of acute psychosis symptoms.
Search for other papers by Ilse C A Bakker in
Google Scholar
PubMed
Search for other papers by Chris D Schubart in
Google Scholar
PubMed
Search for other papers by Pierre M J Zelissen in
Google Scholar
PubMed
Summary
In this report, we describe a female patient with both prolactinoma and psychotic disorder who was successfully treated with aripiprazole, a partial dopamine 2 receptor agonist. During the follow-up of more than 10 years, her psychotic symptoms improved considerably, prolactin levels normalised and the size of the prolactinoma decreased. This observation may be of clinical relevance in similar patients who often are difficult to treat with the regular dopaminergic drugs.
Learning points
-
Prolactinoma coinciding with psychosis can represent a therapeutic challenge.
-
In contrast to many other antipsychotic drugs, aripiprazole is associated with a decrease in prolactin levels.
-
Aripiprazole can be a valuable pharmaceutical tool to treat both prolactinoma and psychosis.
