Organic delusional [schizophrenia like] disorder caused by a primary brain disease

Abstract

One of the possible reasons – hyperprolactinemia caused by prolactinoma. In most cases prolactinoma simptoms include infertility, headaches, oligomenorrhea or amenorrhea, galactorrhea, very rarely – acute psychosis. When prolactinemia is present and its secondary causes are excluded, diagnostic gold standart is brain MRI with contrast. If the test is unavailable or there are contrindications of doing it, head CT with intravenous contrast can be useful, but is less informative. Initial choice of treatment of hyperprolactinemia should be dopamine agonists – cabergoline, bromocriptine. Safest choice of treatment of psychosis with hyperprolactinemia is aripiprazole, quetiapine may be an alternative. We report the case of a 27-year-old woman with prolactinoma and hyperprolactinemia induced acute psychosis. Key words: prolactinoma, hyperprolactinemia, acute psychosis.