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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Available from: Mary V. Seeman
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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.
    Full-text · Article · May 2013 · Reproductive Biology and Endocrinology
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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.
    Full-text · Article · Apr 2012 · Maturitas
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    ABSTRACT: Introduction: Pregnancy delusions have usually been considered as symptoms of psychotic disorders in opposition to the hysterical and psychosomatic nature of pseudocyesis, though several authors have described some semiologic intersection between the two phenomena. Method: Introduction of four cases of patients with pregnancy delusions as well as review and discussion of relevant bibliography. Results: In fact, there are symptoms shared by pregnancy delusions psychosis and pseudocyesis, without detriment of nosological differentiation between the two phenomena. There is certain confusion regarding conceptual and terminological issues that does not contribute to mark precise boundaries. Conclusion: A comprehensive and holistic approach for the study of pseudocyesis and pregnancy delusion is proposed. Maybe, these disorders are more frequently observed in Latin America.
    Full-text · Article · Mar 2012 · Revista Colombiana de Psiquiatria
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