Delírio de Gravidez Secundário a Hiperprolactinémia Induzida por Antipsicóticos: Caso Clínico
DOI:
https://doi.org/10.51338/rppsm.689Palavras-chave:
Antipsicóticos, Aripiprazol, Delírios, Gravidez, HiperprolactinémiaResumo
Descrevemos o caso clínico de uma mulher de 33 anos de idade, com o diagnóstico de Esquizofrenia e quatro internamentos prévios em serviços agudos de Psiquiatria. Após o seu último internamento, aos 33 anos, a doente encontrava-se estável sob terapêutica com injetável de longa duração de palmitato de paliperidona 150mg mensal. Seis meses após a alta, ao longo do seguimento psiquiátrico, a doente apresentou um quadro caracterizado por delírio de gravidez e alucinações somáticas. Os resultados dos testes laboratoriais demonstraram hiperprolactinémia (185ng/mL) e valores negativos de HCG. Foi iniciada terapêutica com aripiprazol 5mg, que resultou na remissão de sintomas psicóticos ao fim de um mês.
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Das S, Prasad S, Kumar SA, Makonyonga RD, Saadoun M, Mergler R. Delusion of pregnancy: a case report and literature review. Clin Med Insights Case Rep. 2023;16:11795476231161169. doi: 10.1177/11795476231161169. DOI: https://doi.org/10.1177/11795476231161169
Bera SC, Sarkar S. Delusion of pregnancy: a systematic review of 84 cases in the literature. Indian J Psychol Med. 2015;37:131-7. doi: 10.4103/0253-7176.155609. DOI: https://doi.org/10.4103/0253-7176.155609
Seeman MV. Pseudocyesis, delusional pregnancy, and psychosis: the birth of a delusion. World J Clin Cases. 2014;2:338-44. doi: 10.12998/wjcc.v2.i8.338. DOI: https://doi.org/10.12998/wjcc.v2.i8.338
Sharma M, Singh R, Sahu S, Pruthi S. Delusion of pregnancy: case series. Indian J Psychiatry. 2024;66:576-80. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_699_23. DOI: https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_699_23
Gogia S, Grieb A, Jang A, Gordon MR, Coverdale J. Medical considerations in delusion of pregnancy: a systematic review. J Psychosom Obstet Gynaecol. 2022;43:51-7. doi: 10.1080/0167482X.2020.1779696. DOI: https://doi.org/10.1080/0167482X.2020.1779696
Ahuja N, Moorhead S, Lloyd AJ, Cole AJ. Antipsychotic-induced hyperprolactinemia and delusion of pregnancy. Psychosomatics. 2008;49:163-7. doi: 10.1176/appi.psy.49.2.163. DOI: https://doi.org/10.1176/appi.psy.49.2.163
Ali JA, Desai KD, Ali LJ. Delusions of pregnancy associated with increased prolactin concentrations produced by antipsychotic treatment. Int J Neuropsychopharmacol. 2003;6:111-5. doi: 10.1017/S1461145703003365. DOI: https://doi.org/10.1017/S1461145703003365
Holt RIG. Medical causes and consequences of hyperprolactinaemia: a context for psychiatrists. J Psychopharmacol. 2008;22:28-37. doi: 10.1177/0269881107087951. DOI: https://doi.org/10.1177/0269881107087951
Cookson J, Hodgson R, Wildgust HJ. Prolactin, hyperprolactinaemia and antipsychotic treatment: a review and lessons for treatment of early psychosis. J Psychopharmacol. 2012;26:42-51. doi: 10.1177/0269881112442016. DOI: https://doi.org/10.1177/0269881112442016
Qi-Lytle X, Sayers S, Wagner EJ. Current review of the function and regulation of tuberoinfundibular dopamine neurons. Int J Mol Sci. 2024;25:110. doi: 10.3390/ijms25010110. DOI: https://doi.org/10.3390/ijms25010110
Kesby JP, Eyles DW, McGrath JJ, Scott JG. Dopamine, psychosis and schizophrenia: the widening gap between basic and clinical neuroscience. Transl Psychiatry. 2018;8:30. doi: 10.1038/s41398-017-0071-9. DOI: https://doi.org/10.1038/s41398-017-0071-9
de Bartolomeis A, Tomasetti C, Iasevoli F. Update on the mechanism of action of aripiprazole: translational insights into antipsychotic strategies beyond dopamine receptor antagonism. CNS Drugs. 2015;29:773-99. doi: 10.1007/s40263-015-0278-3. DOI: https://doi.org/10.1007/s40263-015-0278-3
Hummer M, Huber J. Hyperprolactinaemia and antipsychotic therapy in schizophrenia. Curr Med Res Opin. 2004;20:189-97. doi: 10.1185/030079903125002865. DOI: https://doi.org/10.1185/030079903125002865
Tewksbury A, Olander A. Management of antipsychotic-induced hyperprolactinaemia. Ment Health Clin. 2016;6:185-90. doi: 10.9740/mhc.2016.07.185. DOI: https://doi.org/10.9740/mhc.2016.07.185
Hu LY, Lee YT, Lu T, Hung MB, Hung YY. Using aripiprazole to treat new-onset hyperprolactinaemia-related delusion of pregnancy. Aust N Z J Psychiatry. 2015;49:946. doi: 10.1177/0004867415589796. DOI: https://doi.org/10.1177/0004867415589796
Meng M, Li W, Zhang S, Wang H, Sheng J, Wang J, et al. Using aripiprazole to reduce antipsychotic-induced hyperprolactinaemia: meta-analysis of currently available randomized controlled trials. Shanghai Arch Psychiatry. 2015;27:4-17. doi: 10.11919/j.issn.1002-0829.215014.
Li X, Tang Y, Wang C. Adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinaemia: meta-analysis of randomized controlled trials. PLoS One. 2013;8:e70179. doi: 10.1371/journal.pone.0070179. DOI: https://doi.org/10.1371/journal.pone.0070179
Soomro F, Periasamy D, Isakov O, Aguilar-Henriquez A, Abzakh S. Efficacy of aripiprazole for the management of antipsychotic-induced hyperprolactinaemia: a retrospective case series. Int J Clin Stud Med Case Rep. 2024;41:001005. doi: 10.46998/IJCMCR.2024.41.001005. DOI: https://doi.org/10.46998/IJCMCR.2024.41.001005
Jiang Q, Li T, Zhao L, Sun Y, Mao Z, Xing Y, et al. Treatment of antipsychotic-induced hyperprolactinaemia: an umbrella review of systematic reviews and meta-analyses. Front Psychiatry. 2024;15:1337274. doi: 10.3389/fpsyt.2024.1337274. DOI: https://doi.org/10.3389/fpsyt.2024.1337274
