CASE STUDY 2 - Psychiatric patient - Schizophrenia
Gender: Female
Age: 30 years
Diagnosis: Schizophrenia
Anamnesis: She did not tolerate quetiapine in a higher dose than 600 mg (sedation), now she
uses Xeplion 100 mg every 4 weeks.
Patient has been hospitalized, because she had Séglas hallucinations. Clinicians
decided to add a orally paliperidone 3 mg daily, but still without effect. Last
laboratory test showed a decreased level of thyroid hormones and prolactin level
1131,2 mIU/L.
Medication/Dose:
Paliperidone 3 mg 1 – 0 – 0
Aripiprazole 10 mg 3 – 0 – 0
Escitalopram 5 mg 3 – 0 – 0
Lithium 100 mg 2 – 2 – 2
Quetiapine 100 mg 1 – 1 – 0
Quetiapine ret 300 mg 0 – 0 – 1
Lamotrigine 25 mg 1 – 0 – 0
Tasks:
1. Find all drugs which can cause a hyperprolactinemia
2. Suggest a change of medication, because of a high prolactin level
3. Comment if it is possible to increase doses of used medicaments, and which you recommend to
increase
4. Think which a new drug can be used (patient has hallucinations)
Possible explanation:
Drugs caused a hyperprolactinemia, which is normally under 500 mIU/L (2-20 ng/mL)