Galactorreia Normoprolactinémica Induzida por Fluoxetina: Um Relato de Caso
DOI:
https://doi.org/10.51338/rppsm.712Palavras-chave:
Fluoxetina/efeitos adversos, Galactorreia/induzida quimicamenteResumo
A galactorreia normoprolactinémica constitui um efeito adverso raro dos inibidores seletivos da recaptação da serotonina, documentado sobretudo em relatos de caso. Apresentamos o caso de uma mulher de 32 anos, com perturbação de personalidade borderline e perturbação de ingestão compulsiva, que desenvolveu secreção mamilar leitosa bilateral e ingurgitamento mamário após titulação de fluoxetina para 80 mg/dia. A avaliação analítica, incluindo doseamentos seriados de prolactina sérica, não evidenciou alterações. O estudo imagiológico – ecografia mamária, ginecológica e ressonância magnética cerebral – excluiu patologia orgânica. A redução para 20 mg/dia determinou melhoria parcial, persistindo secreção com compressão mamária no quotidiano, com resolução após suspensão total da fluoxetina. O agravamento subsequente da ingestão compulsiva fundamentou a introdução de bupropiona 150 mg/dia, com resposta favorável. A Escala de Naranjo atribuiu à fluoxetina causalidade provável. Este caso contribui para a caracterização e discussão dos mecanismos fisiopatológicos da galactorreia normoprolactinémica induzida por inibidores seletivos da recaptação da serotonina.
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