Delusion of Pregnancy Secondary to Antipsychotic-Induced Hyperprolactinemia: A Case Report
DOI:
https://doi.org/10.51338/rppsm.689Keywords:
Antipsychotic Agents, Aripiprazole, Delusions, Hyperprolactinemia, PregnancyAbstract
We report the case of a 33-year-old woman diagnosed with schizophrenia, with 4 previous psychiatric hospitalizations. After her last hospitalization, at the age of 33 years old, she was stable under treatment with long-acting injectable paliperidone palmitate 150 mg monthly. Six months after discharge, she presented with delusion of pregnancy and somatic hallucinations. Laboratory tests results showed hyperprolactinemia (185 ng/mL) and a negative hCG. Aripiprazole 5 mg was initiated, resulting in remission of psychotic symptoms within one month.
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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.
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.
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.
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.
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.
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.
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.
Holt RIG. Medical causes and consequences of hyperprolactinaemia: a context for psychiatrists. J Psychopharmacol. 2008;22:28-37. doi: 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.
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.
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.
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.
Hummer M, Huber J. Hyperprolactinaemia and antipsychotic therapy in schizophrenia. Curr Med Res Opin. 2004;20:189-97. doi: 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.
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.
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.
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.
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.
