Important teaching for women in their childbearing years who are receiving antipsychotic medications includes

Important teaching for women in their childbearing years who are receiving antipsychotic medications includes Correct Answer Continuing previous use of contraception during periods of amenorrhea

Concept:

  • Many antipsychotic drugs used to treat schizophrenia can cause amenorrhea in a significant proportion of women.
  • Hormonal side effects of antipsychotic medication, such as amenorrhea, can complicate the lives of women, and yet they have been relatively neglected in both research and clinical practice.
  • The mechanism by which antipsychotics stop menstruation is not totally understood, but hyperprolactinemia secondary to dopamine blockade is central.
  • It is know as Antipsychotic‐induced Amenorrhoea.

Explanation:

  • Although many drugs raise prolactin levels, this occurs more commonly with antipsychotics than with any other class of drugs.
  • Elevated prolactin leads to disturbances in the secretion of gonadotrophin-releasing hormone, which
    in turn results in menstrual irregularities and amenorrhea.
  • Hyperprolactinemia is induced mainly by first-generation antipsychotic drugs, amisulpride, and risperidone.
  • Interventions for management of Antipsychotic‐induced Amenorrhoea:
    • Reduction in dosage
    • Switching antipsychotic drug
    • Discontinuing drug
    • Follow ups for treatment evaluation.
  • Continuing previous use of contraception during periods of amenorrhea as antipsychotic‐induced amenorrhoea is not reliable for contraeption effect.

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