Pediatric emergency medicine trisk 1015 1015
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TABLE 51.3
PARTIAL LIST OF DRUGS THAT CAN CAUSE
HYPERPROLACTINEMIA AND/OR GALACTORRHEA
1. Antipsychotic and antidepressant agents
Phenothiazines (e.g., chlorpromazine [Thorazine], clomipramine [Anafranil],
fluphenazine [Prolixin], prochlorperazine [Compazine], thioridazine
[Mellaril])
Haloperidol (Haldol)
Pimozide (Orap)
Risperidone (Risperdal)
Thiothixene (Navane)
2. Drugs used to treat gastrointestinal disorders
Cimetidine (Tagamet)
Metoclopramide (Reglan)
3. Antihypertensive agents
Methyldopa (Aldomet)
Reserpine (Hydromox, Serpasil, others)
Verapamil (Calan, Isoptin)
4. Opiates
Codeine
Morphine
The administration of exogenous progestin is often used by specialists as an in
vivo test of ovarian and endometrial function for oligomenorrheic patients with
the supposition that “withdraw flow,” if it appears, provides the patient and her
physician with tangible evidence of the basic integrity of the organs and the
hypothalamic–pituitary axis. For diagnosis in adolescents, however, laboratory
investigation is much preferable to progestin administration. Keep in mind,
however, that nearly all nonpregnant adolescents with oligomenorrhea will have a
withdrawal bleed; laboratory investigation may still be recommended.
Appropriate follow-up will be essential.
ACKNOWLEDGMENTS
We would like to thank Dr. Jennifer H. Chuang and Dr. Jan Paradise for their
work on earlier editions of this chapter.
