Treating prolactinoma and psychosis: Medication and cognitive behavioural therapy.

D.H. Nieman; A.L. Sutterland; J. Otten; H.E. Becker; M.L. Drent; M. van der Gaag; M. Birchwood; L. de Haan

doi:https://doi.org/10.1136/bcr.07.2010.3185

Treating prolactinoma and psychosis: Medication and cognitive behavioural therapy.

D.H. Nieman, A.L. Sutterland, J. Otten, H.E. Becker, M.L. Drent, M. van der Gaag, M. Birchwood, L. de Haan

Research output: Contribution to journal › Article › Academic › peer-review

3 Citations (Scopus)

Abstract

The patient in this case report had two severe medical conditions that require oppositional treatment: prolactinoma and psychosis. A prolactinoma is a benign tumour of the pituitary gland that produces prolactin. Dopamine agonist medication is the first-line treatment in patients with prolactinoma. The psychotic symptoms started after a dosage increase of a dopamine D2-receptor agonist. Several antipsychotic medications were tried with and without the dopamine D2-receptor agonist, but severe command hallucinations remained. Cognitive behavioural therapy (CBT) was added which reduced the impact of the hallucinations to a great extent, indicating that CBT can have an additional positive effect in prolactinoma patients with psychosis that shows incomplete recovery after antipsychotic medication. Future research should be aimed at the severe and prolonged side effects of dopamine agonists in the treatment of prolactinoma patients with multiple risk factors for a psychotic decompensation. Copyright 2011 BMJ Publishing Group. All rights reserved.

Original language	English
Pages (from-to)	bcr0720103185
Journal	BMJ Case Reports
Volume	2011
DOIs	https://doi.org/10.1136/bcr.07.2010.3185
Publication status	Published - 2011

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https://doi.org/10.1136/bcr.07.2010.3185

Cite this

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title = "Treating prolactinoma and psychosis: Medication and cognitive behavioural therapy.",

abstract = "The patient in this case report had two severe medical conditions that require oppositional treatment: prolactinoma and psychosis. A prolactinoma is a benign tumour of the pituitary gland that produces prolactin. Dopamine agonist medication is the first-line treatment in patients with prolactinoma. The psychotic symptoms started after a dosage increase of a dopamine D2-receptor agonist. Several antipsychotic medications were tried with and without the dopamine D2-receptor agonist, but severe command hallucinations remained. Cognitive behavioural therapy (CBT) was added which reduced the impact of the hallucinations to a great extent, indicating that CBT can have an additional positive effect in prolactinoma patients with psychosis that shows incomplete recovery after antipsychotic medication. Future research should be aimed at the severe and prolonged side effects of dopamine agonists in the treatment of prolactinoma patients with multiple risk factors for a psychotic decompensation. Copyright 2011 BMJ Publishing Group. All rights reserved.",

author = "D.H. Nieman and A.L. Sutterland and J. Otten and H.E. Becker and M.L. Drent and {van der Gaag}, M. and M. Birchwood and {de Haan}, L.",

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T1 - Treating prolactinoma and psychosis: Medication and cognitive behavioural therapy.

AU - Nieman, D.H.

AU - Sutterland, A.L.

AU - Otten, J.

AU - Becker, H.E.

AU - Drent, M.L.

AU - van der Gaag, M.

AU - Birchwood, M.

AU - de Haan, L.

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AB - The patient in this case report had two severe medical conditions that require oppositional treatment: prolactinoma and psychosis. A prolactinoma is a benign tumour of the pituitary gland that produces prolactin. Dopamine agonist medication is the first-line treatment in patients with prolactinoma. The psychotic symptoms started after a dosage increase of a dopamine D2-receptor agonist. Several antipsychotic medications were tried with and without the dopamine D2-receptor agonist, but severe command hallucinations remained. Cognitive behavioural therapy (CBT) was added which reduced the impact of the hallucinations to a great extent, indicating that CBT can have an additional positive effect in prolactinoma patients with psychosis that shows incomplete recovery after antipsychotic medication. Future research should be aimed at the severe and prolonged side effects of dopamine agonists in the treatment of prolactinoma patients with multiple risk factors for a psychotic decompensation. Copyright 2011 BMJ Publishing Group. All rights reserved.

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