A 38-year-old man with schizophrenia taking risperidone reports galactorrhoea and loss of libido. Which adverse effect explains these symptoms?
Answer and explanation
Correct answer: C. Hyperprolactinaemia from dopamine D2 blockade
- Step 1: Dopamine normally inhibits prolactin secretion from the pituitary.
- Step 2: Blocking D2 receptors raises prolactin and can cause galactorrhoea, amenorrhoea and sexual dysfunction.
Answer
Hyperprolactinaemia from dopamine D2 blockade.
Why not the others: Tardive dyskinesia caused by long-term dopamine blockade in the striatum: Tardive dyskinesia is an involuntary movement disorder. Serotonin syndrome caused by combined serotonergic medicines: Serotonin syndrome causes clonus and hyperthermia. Hypothyroidism caused by the antipsychotic acting on the thyroid gland: Risperidone does not cause hypothyroidism in this manner.
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