Antipsychotic-induced amenorrhea

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Journal of Mental Health (Impact Factor: 1.01). 10/2011; 20(5):484-91. DOI: 10.3109/09638237.2011.586741
Source: PubMed


Many antipsychotic drugs used to treat schizophrenia can cause amenorrhea in a significant proportion of women. The overall impact of this side effect has been little studied.
To review the literature on the meaning of menstruation to women.
This is a literature review of the meanings of menstruation to women in general, to women of different cultures, and to women with schizophrenia.
Many women feel ambivalent with respect to menstruation. Its loss can produce difficulties for women suffering from schizophrenia, such as failure to use contraception, pseudocyesis, denial of pregnancy, erroneous perception of early menopause, or loss of the feeling of femininity.
Attempts should be made to avoid the antipsychotic side effect of amenorrhea.

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    • "Finally, erroneous pseudocyesis refers to cases when the woman erroneously misinterprets symptoms suggestive of pregnancy, including amenorrhea, galactorrhea and/or abdominal enlargement, resulting from either organic diseases (e.g., hormone-secreting tumor [21-23], alcoholic liver disease [24], cholecystitis [25], urinary tract infection complicated by urine retention [26]) or exposure to a substance (e.g., a medication [27-30]). "
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    ABSTRACT: This literature review on pseudocyesis or false pregnancy aims to find epidemiological, psychiatric/psychologic, gynecological and endocrine traits associated with this condition in order to propose neuroendocrine/endocrine mechanisms leading to the emergence of pseudocyetic traits. Ten women from 5 selected studies were analyzed after applying stringent criteria to discriminate between cases of true pseudocyesis (pseudocyesis vera) versus delusional, simulated or erroneous pseudocyesis. The analysis of the reviewed studies evidenced that pseudocyesis shares many endocrine traits with both polycystic ovarian syndrome and major depressive disorder, although the endocrine traits are more akin to polycystic ovarian syndrome than to major depressive disorder. Data support the notion that pseudocyetic women may have increased sympathetic nervous system activity, dysfunction of central nervous system catecholaminergic pathways and decreased steroid feedback inhibition of gonadotropin-releasing hormone. Although other neuroendocrine/endocrine pathways may be involved, the neuroendocrine/endocrine mechanisms proposed in this review may lead to the development of pseudocyetic traits including hypomenorrhea or amenorrhea, galactorrhea, diurnal and/or nocturnal hyperprolactinemia, abdominal distension and apparent fetal movements and labor pains at the expected date of delivery.
    Reproductive Biology and Endocrinology 05/2013; 11(1):39. DOI:10.1186/1477-7827-11-39 · 2.23 Impact Factor
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    • "This was because antipsychotics block dopamine transmission, which normally inhibits prolactin secretion from the pituitary gland. Rising prolactin levels (which can be triggered not only by antipsychotics but also by diet, other drugs, or general stress) and resulting in amenorrhea can lead to the erroneous perception of early menopause in women with schizophrenia [5]. "
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    ABSTRACT: The purpose of this review is to optimize treatment for women with schizophrenia during the menopause. Recommendations are based on a relatively sparse literature derived from searching PubMed, PsychINFO, SOCINDEX with appropriate search terms for all years subsequent to 2000. Attention needs to be paid to menopausal symptoms in women with schizophrenia and to the possibility that psychotic symptoms may worsen at this time and that general health may deteriorate. Antipsychotic treatment may need to be modified and cardiac and metabolic health indices closely monitored.
    Maturitas 04/2012; 72(2):117-20. DOI:10.1016/j.maturitas.2012.03.008 · 2.94 Impact Factor
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    ABSTRACT: Objective: To explore the meaning of taking antipsychotic medication in a population with schizophrenia. Method: A literature review of publications on the meaning of medication was conducted using PsycINFO, Medline, and SOCINDEX databases (2001-2012) and search terms attitude or meaning plus antipsychotics or neuroleptics. Based on this search, 110 articles were found, 60 of which were judged relevant to the goal of this article. A recently published expert consensus guideline was also used to better understand current thinking about medication adherence issues in patients with severe mental illness. Quotations from patients attending a women's clinic for psychosis were used to expand on themes found in the literature. Results: Themes extracted from the reviewed literature fell into three main categories: a) control by and of medication, b) dependence on medication and on the prescriber, and c) stigma resulting from medication use. These themes contrast with the usual medical associations with medication (e.g., symptom relief or side effects). Conclusion: Shared discussion of beliefs about medication between patient and care provider allows wider exploration of personal meanings that can help establish therapeutic relationships and integrate psychological therapy with psychopharmacology.
    Journal of Psychiatric Practice 09/2012; 8(5):338-348. DOI:10.1097/01.pra.0000419818.60505.95 · 1.34 Impact Factor
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May 28, 2014