A 30 year old patient of schizophrenia on antipsychotics presents with amenorrhea and galactorrhea. Which of the following antipsychotic should she be shifted to:-
High-Yield Explanation
The history is suggestive of hyperprolactinemia. The drugs which are mostly associated with hyperprolactinemia include typical antipsychotics, risperidone, paliperidone, sulpiride and amisulpride. High levels of serum prolactin are associated with decreased libido, impaired sexual arousal, impaired orgasm, galactorrhea (milk production), and over time gynecomastia (breast enlargement). Aripiprazole, due to paial dopamine agonist, usually decreases serum prolactin and hence should be used in this case.