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So I've been on Risperdal since February, and starting in late August I started noticing occasional slight lactation.  Now, it's a little weird to see, but it doesn't really bother me, and I like Risperdal.

Is having raised prolactin levels a bad thing?  Should I stop Risperdal, or should I keep on it, since it works and lactating doesn't really bother me?

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A large percentage of breast cancers are prolactin dependant (aka "fed" by prolactin).

You decide.

Kassiane

<{POST_SNAPBACK}>

I agree that it is definitely a risk factor for breast cancer.  I also think that it is likely that the lactation will increase.  Mine was not very significant at first, but it got really bothersome pretty quickly.

Katie ;)

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Hmmm. I have a 2 month old daughter and I bottle feed her so my milk had basically just 'dried up' and now that I am taking risperdal (I have only been on it for about a month) I am lactating again. It isnt much right now but if its going to get worse then I'm not sure im ok with that.

I wasnt aware of the increased breast cancer risk either.

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i second what katie says...the lactation tends to get worse and gets really annoying really quickly.

oh and thanks Kassi for that info on breast cancer...i didn't know that.

<{POST_SNAPBACK}>

How quickly?  I've noticed it twice in 7 months, and it's only been about a drop each time.

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I have a pituitary gland problem that causes me to lactate.  I have to take a prolactin inhibitor called cabergoline to keep my levels down (they would sit at 44 normally - with cabergoline, they sit at 7).

My Pdoc had me take Risperdal full strength for two weeks and I started to lactate.  Right through my shirt.  As far as I'm concerned, that's some heavy shit.  The week I titrated off was much better.

My Pdoc refuses to put/keep anyone on Risperdal for anything other than emergency intervention not even because of the lactation, but because of the potential for permanent neurological side effects/damage. (akathesia sp?)

Bummer, too, because it was the first (and only, so far) drug that kicked the shit out of my mania.

6

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My Pdoc refuses to put/keep anyone on Risperdal for anything other than emergency intervention not even because of the lactation, but because of the potential for permanent neurological side effects/damage. (akathesia sp?)

This mentality pisses me off.  If the patient is aware of the risks, they should be the one to make the final decision over if the risk is worth it or not. 

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Can you tell me anything more about cabergoline?

<{POST_SNAPBACK}>

Background on Risperdal from the source below:

"Many antipsychotics cause hyperprolactinemia because their antidopaminergic activity prevents dopamine from inhibiting prolactin secretion. Among the atypicals, however, only risperidone significantly elevates prolactin. Caracci et al also demonstrated a two- to four-fold greater prolactin elevation with risperidone than with typical antipsychotics and noted that hyperprolactinemia with risperidone could occur at standard daily doses."

The following seems to say that Cabergoline has a lower incidence of provoking psychosis while doing the job.

Information on dealing with hyperprolactinaemia due to Risperdal:

Treatment options.

-When patients develop hyperprolactinemia, switching to another antipsychotic is not the only option.  Standard therapies for hyperprolactinemia

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Can you tell me anything more about cabergoline?

<{POST_SNAPBACK}>

Background on Risperdal from the source below:

"Many antipsychotics cause hyperprolactinemia because their antidopaminergic activity prevents dopamine from inhibiting prolactin secretion. Among the atypicals, however, only risperidone significantly elevates prolactin. Caracci et al also demonstrated a two- to four-fold greater prolactin elevation with risperidone than with typical antipsychotics and noted that hyperprolactinemia with risperidone could occur at standard daily doses."

The following seems to say that Cabergoline has a lower incidence of provoking psychosis while doing the job.

Information on dealing with hyperprolactinaemia due to Risperdal:

Treatment options.

-When patients develop hyperprolactinemia, switching to another antipsychotic is not the only option.

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No, it is a never ending escalation.

You raise the Risperdal, your pituitary gland increases your prolactin production. 

The idea behind using Cabergoline is to drop people into a safe range by giving them dopamine.

But if the whole reason you're using Risperdal is because you have too much dopamine floating around.... well, it just doesn't make a whole lot of sense in my book.

But I'm not a pharmacologist, and what seems logical on the surface may be completely different on the molecular level... so I'd check with a professional on this one.

6

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I think that you need to consider another atypical.  I know how hard it is to stop taking something that worked wonders because of one SE that persists.  Many people take meds that help control symptoms caused by another medicine.  However, there is a chance of being thrown off by adding another medicine to a stable combo.  Then you end up with another problem.  It seems pretty extreme to take cabergoline to stop the lactation.  There are many add-ons out there, but I have not heard of that drug being used to deal with Risperdal induced lactation.

I hope you mention this serious SE to your doctor.  You may want to have your prolactin levels checked to get a better idea of the size of the problem.

Katie ;)

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