A 40-year old female suffered from an episodic illness of 7 years and was diagnosed as recurrent depressive disorder. After 15 days of fluoxetine 40 mg and amitriptyline 25 mg, she reported heaviness in breasts and increased breast size with creamy white discharge. Serum PRL level was raised (333 ng/ml). Hence, she was switched to sertraline, and after 1 month, breast secretions stopped completely with normal PRL. Due to relapse in depressive symptoms, she was switched back to fluoxetine as a single agent, and dose was gradually hiked to 60 mg. Now, she is asymptomatic for the past 15 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.