{"paper_id":"878b3ee7-03f7-4a71-ae51-9e4ddc94f044","body_text":"A cross sectional study on antipsychotic induced amenorrhoea in women attending a tertiary care centre in South India\nDOI:\nhttps://doi.org/10.18203/2320-6012.ijrms20192123Keywords:\nAmenorrhoea, Antipsychotic, Hyperprolactinemia, Risk factorsAbstract\nBackground: Absence of menstrual period in a woman of reproductive age group could be physiological or pathological. Ascertaining the cause for this is a common clinical scenario faced by physicians. It is also a common clinical problem in women who are on treatment with antipsychotic medication. This cross-sectional study aimed to assess the occurrence of antipsychotic induced amenorrhoea among women aged 18-45 years, attending outpatient services of a tertiary care setting, the factors associated and to assess the effective strategies of treatment.\nMethods: Retrospective chart review of clinical details of women in the reproductive age group who fulfilled the inclusion criteria was carried out. They were divided into two groups: Group A included 84 women with antipsychotic induced amenorrhea and Group B included 94 women on antipsychotics and had normal menstrual cycles. Various factors and strategies which worsened or alleviated the symptoms were noted.\nResults: Women who were less than 35 years of age, on antipsychotic treatment for more than two years duration (52;83.9%) and those who were on treatment with Risperidone (69;73.4%) were identified as having the risk of developing antipsychotic induced amenorrhoea. The strategy of switch of medication to prolactin sparing antipsychotic was more effective in regularising the menstrual cycles (43;87.8%).\nConclusions: In women presenting with amenorrhoea, a possible medication induced aetiology need to be considered, especially use of antipsychotics. Further understanding of the complexities of this relationship may help to guide the assessment and proper treatment of women with antipsychotic related amenorrhoea.\nMetrics\nReferences\nSeeman MV. Antipsychotic-induced amenorrhea. J Ment Health Abingdon Engl. 2011 Oct;20(5):484-91.\nBeausang CC, Razor AG. Young western women’s experiences of menarche and menstruation. Health Care Women Int. 2000 Sep;21(6):517-28.\nSerri O, Chik CL, Ur E, Ezzat S. Diagnosis and management of hyperprolactinemia. CMAJ. 2003 Sep 16;169(6):575-81.\nBerga SL, Loucks TL. The diagnosis and treatment of stress-induced anovulation. Minerva Ginecol. 2005 Feb;57(1):45-54.\nMary V Seeman. Antipsychotic induced amenorrhea. J Ment Health. 2011;20(5):484-91.\nSnyder P. UpToDate [Internet]. Clinical manifestations and evaluation of hyperprolactinemia. Available at: https://www.uptodate.com/contents/clinical-manifestations-and-evaluation-of hyperprolactinemia\nRavan JR, Dholakia SY. Interventions for antipsychotic-induced amenorrhoea. Cochrane Schizophrenia Group, editor. Cochrane Database Syst Rev [Internet]. 2016 Dec 1 [Cited 2018 Mar 19]. Available at: http://doi.wiley.com/10.1002/14651858.CD012452\nDavid Semple, Roger Smyth. Hyperprolactinemia with antipsychotics. In: Oxford Handbook of Psychiatry 3rd edition. 3rd Ed. Oxford University Press; 2018:936.\nBargiota SI, Bonotis KS, Messinis IE, Angelopoulos NV. The Effects of Antipsychotics on Prolactin Levels and Women’s Menstruation. Schizophr Res Treat. 2013;2013:1-10.\nTsuboi T, Bies RR, Suzuki T, Mamo DC, Pollock BG, Graff-Guerrero A, et al. Hyperprolactinemia and estimated dopamine D2 receptor occupancy in patients with schizophrenia: analysis of the CATIE data. Prog Neuropsychopharmacol Biol Psychiatry. 2013 Aug 1;45:178-82.\nSkultans V. The Symbolic Significance of Menstruation and the Menopause. Man. 1970;5(4):639-51.\nKinon BJ, Gilmore JA, Liu H, Halbreich UM. Prevalence of hyperprolactinemia in schizophrenic patients treated with conventional antipsychotic medications or risperidone. Psychoneuroendocrinol. 2003 Apr;28 Suppl 2:55-68.\nPaul T, Ravan JR, Thomas N, Thomas N, Samuel P, Braganza D. Risperidone associated changes in prolactin and bone mineral density: a study from South India. In BioScientifica; 2013. [Cited 2019 Apr 1]. Available at: https://www.endocrine-abstracts.org/ea/0031/ea0031P17\nFinny P, Stephen C, Jacob R, Tharyan P, Seshadri MS. Jasmine flower extract lowers prolactin. Trop Doct. 2015 Apr 1;45(2):118-22.\nKinon BJ, Gilmore JA, Liu H, Halbreich UM. Hyperprolactinemia in response to antipsychotic drugs: characterization across comparative clinical trials. Psychoneuroendocrinol. 2003 Apr;28 Suppl 2:69-82.\nSwarnalatha M, Padma P, Vijayalaxmi D, Neela A. Antipsychotic induced hyperprolactinemia and menstrual disorders in women - A cross-sectional study. IOSR J Dent Med Sci. 2015;14:36-40.","source_license":"CC0","license_restricted":false}