Fluoxetine‑Induced Normoprolactinemic Galactorrhea: A Case Report
DOI:
https://doi.org/10.51338/rppsm.712Keywords:
Fluoxetine/adverse effects, Galactorrhea/chemically inducedAbstract
Normoprolactinemic galactorrhea is a rare adverse effect of selective serotonin reuptake inhibitors, documented primarily in case reports. We report the case of a 32‑year‑old woman with borderline personality disorder and binge‑eating disorder who developed bilateral milky nipple discharge and breast engorgement after titration of fluoxetine to 80 mg/day. Laboratory workup, including serial serum prolactin measurements, yielded no significant abnormalities. Imaging studies – breast and pelvic ultrasonography and brain magnetic resonance imaging – excluded organic pathology. Dose reduction to 20 mg/day led to partial improvement, with discharge persisting upon routine breast compression, with resolution following full discontinuation of fluoxetine. Subsequent worsening of binge‑eating episodes warranted the introduction of bupropion 150 mg/day, with favourable response. The Naranjo Scale attributed probable causality to fluoxetine. This case contributes to the characterisation and pathophysiological discussion of normoprolactinemic galactorrhea induced by selective serotonin reuptake inhibitors.
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