The next few posts will explore in depth the research that has been conducted on the relationship between gynecomastia, prolactin levels and Risperdal. The language quoted in these studies can get quite technical. However, the goal is not to demonstrate that any single study is “world changing” but rather to show how many diverse studies have found the same effect.
The Peculiar Case of Mr. R
On August 1, 2000 researchers published a paper called “Gynecomastia with Risperidone Fluoxetine combination” in Psychiatric Services, Volume 51, No. 8. The authors wrote: “elevation of prolactin levels among patients treated with psychotropic medications and the treatment of hyperprolactinemia have been described over the past three decades. Prolactin secretion by the anterior pituitary is inhibited by dopamine.”
The authors discussed the strange case of “Mr. R,” a 38-year-old single Hispanic man who was diagnosed with bipolar disorder. Physicians believe he developed a brain injury after getting in a car accident. They noted that he was impulsive and that he exhibited “inappropriate social behaviors” and walked with a stiff gait.
The authors reported: “Risperidone 2.5 milligrams twice a day was prescribed for an episode of increased irritability, hyper sexuality, pressured speech, disorganized [and] paranoid thinking… On day 12 of Risperidone treatment, Mr. R complained of galactorrhea. His serum prolactin level on day 13 was 48.2 nanograms per milliliters… on examination, pendulous breasts with bilateral milky, white discharge were noted… Risperidone was stopped on day 14. After a 10 day watch out period, Mr. R’s prolactin level on day 24 had returned to normal… by day 37, Mr. R’s breast size had decreased by 50 percent, and no discharge was noted 23 days after Risperidone was stopped. By day 87, breast size had decreased 75 percent, no discharge was noted… Discharged on day 94, Mr. R’s prolactin level was normal at 12.2 nanograms per milliliter… and his testosterone was normal.”
Another Risperdal Study Contrasts Greatly with the 2003 Study Funded by J&J
Here is another interesting study from the journal of Clinical Psychopharmacology February 1999; Volume 19; issue 1: “Prolactin levels and adverse events in patients treated with Risperidone.” The authors wrote that “hyperprolactinemia [high levels of prolactin]… may arise from a variety of etiologies, including these anti-psychotic agents, presumably because of dopamine receptor blockage.” The authors sought to understand the relationship among Risperdal, blood prolactin levels, and clinical symptoms. They said: “all data from randomized, double blind studies of Risperidone patients with chronic schizophrenia were analyzed.” Unlike the Janssen study (done in 2003), the authors looked at two studies — one of 841 patients and one of 1,884 patients — and found that “Risperidone… produced dose related increases in plasma prolactin levels in men and women… among men, the incidents of adverse events was positively correlated with the Risperidone dose.” (bold added)
For insight into your Risperdal case, call the Davis & Crump team now at 800-277-0300 or email us at info@daviscrump.com.
