High dose paroxetine-induced galactorrhea with normal serum prolactin level: A case report

Abstract

High dose paroxetine-induced galactorrhea with normal serum prolactin level: a case report A 33-year-old woman with no significant psychiatric history began to have depressive and anxiety symptoms that worsened over time. She had depressed mood, loss of interest in her daily household works, reduced sleep and appetite, fatigability and irritability. A provisional diagnosis of depressive disorder was made and she was prescribed 20 mg/day paroxetine with the dose being increased to 60 mg/day at her third outpatient psychiatric appointment. After 2 weeks she noticed milk secretion from both her nipples. There were no abnormalities in blood chemistry, thyroid function tests and beta human chorionic gonadotropin. Magnetic resonance imaging of the hypothalamic/pituitary area was normal. The serum prolactin, FSH, DHEAS and estradiol levels were normal. Because her galactorrhea developed after increasing the paroxetine dosage to 60 mg/day, we reduced the dosage by 10 mg per week. The discharge stopped when we reached a dosage of 30 mg/day paroxetine. The temporal relationship between the paroxetine dose increase and the onset of galactorrhea and between the drug dose decrease and the remission of galactorrhea suggests a possible etiologic role for this drug.