Neuroleptic-induced Irregular Menstruation in Schizophrenic Patients

Choi, Ji Eun; Yoon, Bo Hyun; Yoon, Jin Sang

Abstract

OBJECTIVES
This study was aimed to examine the prevalence of neuroleptic-induced irregular menstruation and its related factors as well as the possible relationship of irregular menstruation with psychopathology and extrapyramidal symptoms in schizophrenic patients.
METHODS
Thirty five schizophrenic inpatients at Naju National Mental Hospital who satisfied the diagnostic criteria of DSM-IV were selected. They had drug-free periods for more than 1 month before admission and had been taking neuroleptics for more than 3 months after admission. From all patients, reliable information regarding the sociodemographic characteristics, the menstrual histories before and after admission and clinical characteristics, including previous and current medications were investigated. The following were also evaluated: Serum prolactin level(by radioimmunoassay), psychopathology(by positive and negative syndrome scale: PANSS), and extrapyramidal symptoms(by extrapyramidal symptom rating scale: ESRS).
RESULTS
Twelve patients(34%) showed regular menstruation and 23 patients(66%) were suffering from irregular menstruation. Of those with irregular menstruation, 13 patients(37%) had oligomenorrhea and 10 patients(29%) had amenorrhea. There were no differences in sociodemographic characteristics and menstrual histories before admission between the regular and irregular menstruation groups. But, the significant differences between the two were found in the following variables: The irregular menstruation group had shorter durations of illness, higher daily doses of current neuroleptics, higher serum prolactin levels, higher scores on the general psychopathology scale of PANSS, and higher scores on the parkinsonian symptom scale, hypokinetic symptom factor and clinical global impression of ESRS.
CONCLUSION
The high prevalence of the irregular menstruation in schizophrenic patients reflects a state of hyperprolactinemia due to the interference of dopamine activity by high doses of neuroleptics.