A 37-year-old female suffered from an episodic illness of 6 years and was diagnosed as recurrent depressive disorder with migraine and hypothyroidism. At the time of presentation, her thyroid function tests were normal on thyroxin 150 mcg/day, and she was on venlafaxine 150 mg, fluoxetine 20 mg, and propranolol 40 mg with minimal improvement and complaints of weight gain, amenorrhea, and galactorrhea. Her serum PRL level was raised (>200). Hence, she was switched to dosulepin 150 mg and propranolol 40 mg. In 1 month, she improved significantly, and breast secretions were stopped completely with normal serum PRL (24 ng/ml). However, due to relapse in depressive symptoms in the next 3 months, the dose of dosulepin was hiked to 225 mg, but after 20 days, she again developed galactorrhea and hyperprolactinemia (170 ng/ml). Finally, she was switched on bupropion 300 mg. In around 1 month, she became asymptomatic (PRL: 21.33 ng/ml) and presently maintaining well on the same medication for the past 6 months.
A 17-year-old girl presented with complaints of episodic shortness of breath, anxiety, and sleep disturbance for about 25 days. Initially, she was prescribed escitalopram 20 mg/day and sertraline 50 mg/day by a physician, and on the 9th day, she reported secretions from the breasts. She was diagnosed as somatoform autonomic dysfunction of respiratory system (F45.33) with galactorrhea. Her serum PRL level was raised (164.4 ng/ml). Then, she was kept on clonazepam 1 mg/day along with psychotherapy sessions. After stopping the medicines, the discharge stopped completely in 10 days. At present, the patient is asymptomatic for the past 3 months and not receiving any psychotropic medications.