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What's the deal with lactation?


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Recently, I uh... lactate. Not a lot, and only when I squeeze my nipples. So it leads me to believe my prolactin levels are too high. I took a lab test, but the bastards sent it to the wrong lab for evaluation so I haven't gotten the results yet.

What are the risks? I know it's not good, but does it require me to go off Geodon or lower the dose? My pdoc doesn't seem to know much, or at least wants to wait to talk about it until we actually get the results. But I want to know the risks now, so I can decide how to deal with it. I'm not willing to give up Geodon unless it poses a serious threat to my health.

Loon, I know you wrote something about this before but I can't find it. I know you have experience, so please help me if you can.

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  • 2 weeks later...

I've been intending to get back to this one.

Just saw this.

http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=16571367

Using aripiprazole to resolve antipsychotic-induced symptomatic hyperprolactinemia: a pilot study.

Lee BH, Kim YK, Park SH.

Department of Psychiatry, Korea University Ansan Hospital, College of Medicine, 516 Go-Jan Dong, Ansan, Kyunggi-Do 425-020, Korea.

OBJECTIVE: To assess the effectiveness of substituting aripiprazole for other antipsychotic drugs taken by stable schizophrenic patients suffering from antipsychotic agent-induced symptomatic hyperprolactinemia. METHODS: Seven female schizophrenic patients with symptomatic hyperprolactinemia (167.6+/-58.0 microg/L) were recruited to take part in an 8-week open label trial of aripiprazole (10-20 mg/day) as a replacement for amisulpride or risperidone. Efficacy was assessed via PANSS and CGI-I scores. Serum prolactin levels were measured at baseline, week 4, and week 8. Data were collected from November, 2004 to May, 2005. RESULTS: At the end of weeks 4, serum prolactin levels were normalized (8.8+/-5.5 microg/L) and hyperprolactinemic symptoms were resolved in all patients. However, aripiprazole treatment was discontinued within 6 weeks for 2 of the 7 subjects due to aggravated auditory hallucinations. CONCLUSION: Results from this admittedly small-scale open-label study indicate that switching to aripiprazole may be useful for resolving antipsychotic-induced hyperprolactinemia and associated symptoms.

That's something to go on anyway.

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i take risperdal adn have the lactation issue, though it used to be much worse than it is now. it used to flow out, and now i have to make drops come out. so it is a lot better.

but i had to make the choice to continue taking it or not, considering the prolactin problems, and i decided to stay on it, and my dose has even been increased.

i did a lot of research in making up my mind. i found that while there have been no studies on this in humans, high prolactin levels in rats have the potential to cause cancers, especially brain cancer, however, it is rare enough that i'm not afraid of it happening to me.

there comes the point when you weigh it- are you more afraid of YOURSELF off of the drug, or what the drug itself could do to you?

i look at the statistics that 10% of bipolar people commit suicide, one of them being my dad. where would i be without my risperdal? i'm much more afraid that i'd hurt myself than i am of that small chance of developing cancer due to risperdal.

now, there are other symptoms associated with high prolactin, such as problems conceiving children. but if you're not on the market to have kids right now, it shouldn't be an issue.

i talked to my pdoc, and we to keep the risperdal. i don't even know how high my prolactin is since we've never tested it. now i'm taking symmetrel to counter the lactation (the risperdal rep said it would help), and the lactation has been minimized, so i think it does help me.

so talk to your pdoc about it and figure out where you stand on that particular issue. there is rat research out there gauging prolactin and results of high prolactin, and that was the closest i could find to what we're discussing. i based my decision on that research, and the statistics on bipolar suicides. i'd rather end up with radiation treatments than in the morgue.

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Thanks, both of you.

I've been on Abilify, 30 mg, and it really didn't do anything. Plus Geodon is one of the few meds that actually works for my depression. I don't think I'm willing to give that up yet.

Loon, I think I can live with those risks. I saw you mentioned in another thread fertility issues, but that they went away after the drug was discontinued?

Oh yeah, the IDIOTS screwed up my test. I have to take a new one.

I talked to my pdoc about this again and she said lactation was usually seen as an unpleasant side effect where you lower the dose to get rid of it, but that it didn't have any known risks.

Also, haven't had it in a while now. Maybe it'll all be alright.

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i haven't read anything indicating that the issue continued, just that during the study there were fertility problems. you know how studies are, rather short term. i got pregnant taking risperdal last year so i don't think it affected my fertility, unless it promoted it!

if you haven't lactated, that's good. your prolactin probably went down. i hardly lactate at all now, i have to make it come out, and then i only get a little bit. i used to get it running down on its own.

i take a drug called symmetrel right now that is allegedly helping keep my lactation down. that is according to the Always Correct risperdal rep. that's what she told my pdoc, so that's what he gave me. i'm happy to know that our medical professionals are trained by such experts as pharma reps! next thing you know he'll be asking me for advice ;)

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