Endocrine Abstracts

Given the increasing incidence in psychiatric pathology, adverse reactions of psychotropic medications, especially the metabolic and endocrine side effects, are encountered more frequently in clinical practice. We present the cases of two female patients with psychiatric pathology, in whom the specific treatment was accompanied by significant endocrine adverse reactions, making the tumoural differential diagnosis very difficult. The first case is of a patient aged 61 years, known with schizophrenia from the age of 27 years and treated for many years with valproic acid, who presented to our clinic for severe virilising syndrome, with a total serum testosterone of 9.2 ng/ml, rising the suspicion of ovarian or adrenal carcinoma. The second case is of a female patient aged 24 years, diagnosed with depressive disorder, in whom treatment with escitalopram and valproate was accompanied by amenorrhea-galactorrhoea syndrome and severe hyperprolactinaemia of 224 ng/ml (more specific for a macroprolactinoma). The pituitary CT scan revealed a microadenoma of 0.4/0.4 cm, generating important issues regarding differential diagnosis. Although endocrine side effects are often not life threatening and are less frequent than neurological side effects, such as sedation, extrapyramidal syndrome and anticholinergic disorders, recognising and correcting them is the key to successful therapy and ensures compliance of the patient with psychiatric pathology.