Infertility after long-acting paliperidone palmitate treatment: a case report

Hyperprolactinemia is a common side effect of antipsychotic treatments. Conventional antipsychotics increase prolactin secretion due to their strong D2 receptor antagonism and long-term dependence on the receptor. Among atypical antipsychotics, risperidone and amisulpride are known to increase prolactin levels as typical antipsychotics. 9-OH risperidone (paliperidone), the active metabolite of risperidone; due to its similar receptor effect profile, it may cause prolactin elevation. Hyperprolactinemia may occur due to the use of paliperidone palmitate. Hyperprolactinemia can lead to galactorrhea, amenorrhea, sexual dysfunction, gynecomastia, hirsutism, and infertility. In patients with hyperprolactinemia, other antipsychotics may be used or aripiprazole may be added to the treatment. In this study, we aimed to present a patient who had severe benefit from long- acting antipsychotic treatment of paliperidone palmitate, but developed hyperprolactinemia during follow-up and the change in prolactin levels back to normal after changing the treatment to long-acting aripiprazole.national emergency transplant list.