| Summary: | Background : Amenorrhea as one of frequent adverse effects associated with the use of atypical antipyschotics is often neglected but can interrupt the compliance of treatment. There are clinical trials regarding improvement of hyperprolactinemia after switching to olanzapine while some trials regarding the opposite and the improvement with aripiprazole. Aripiprazole is an antipsychotic with partial dopamine antagonism and agonism. Its advantageous side effect profile has been described earlier. We reviewed a case in which olanzapine induced amenorrhea normalized without clinical worsening after switching to aripiprazole. Methods : Ms. C, a 36-year-old woman with psychosis, developed menstrual dysfunction and galactorrhea soon after beginning a treatment of olanzapine, 20 mg/day. She reported having monthly menses before regimen. After 3 month of treatment, menses were absent and galactorrhea began. Ms. C was not pregnant. Her prolactin level was 157.20 ng/ml, and an MRI showed no sign of pituitary adenoma. Olanzapine medication was discontinued in the patients because of galactorrhea, and raised liver enzyme activities. Aripiprazole was initiated and titrated to 15 mg/day. Results : After 1 month of aripiprazole treatment, monthly menses resumed and galactorrhea resolved. The serum prolactin fell to a normal level (27.20 ng/ml). Ms. C's psychiatric condition improved and she has remission. Conclusions : Aripiprazole's reduced potential to elevate prolactin may provide a treatment advantage for women with schizophrenia. Moreover, since menstrual cycles may normalize during treatment with aripiprazole, women treated with this drug may have improved fertility when compared with women receiving typical antipsychotics and olanzapine. In this case, aripiprazole treatment resulted in reduction of serum prolactin levels and resolution of galactorrhea. Further studies will be required to assess the comparative effects of aripiprazole and other antipsychotics on prolactin levels and resolution of galactorrhea.
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