It is notable that patients with high emotional stress or physical distress can have hyperprolactinemia and associated amenorrhea or menstrual irregularities related to hypothalamic dysfunctions [Kaplan and Manuck, 2004; Young and Korzun, 2002]. In a 3-year study of women aged 36–45 years [Harlow et al. 2003], those with a history #Idarubicin in vitro keyword# of depression exhibited 1.2 times the rate of perimenopause as nondepressed women. Subjects with Hamilton Rating Scale for Depression [Hedlung and Vieweg, 1979] scores >8 at enrollment had twice the rate of perimenopause after 3 years compared with women without depression. PCOS causes 20% secondary amenorrhea is a prevalent and frequently encountered

endocrine disorder [Lobo and Carmina, 2000]. In a study, 16 of 32 women with PCOS had depression as diagnosed by Sub-fertility Center for Epidemiological Studies – Depression Rating Scale (scores >16) [Rasgon et al. 2000; Inhibitors,research,lifescience,medical Rasgon et al. 2003]. This suggests a high prevalence of depression among women with PCOS, but was limited by possible selection bias, no further diagnostic evaluation for depression, small sample size, and lack of an age-matched control group. A case report describes high dose of alprazolam-induced amenorrhea and galactorrhea

in a 35-year-old unmarried female psychiatric patient [Petrić Inhibitors,research,lifescience,medical et al. 2011]. In another clinical report, there was evidence of pharmacodynamic interactions between citalopram, alprazolam in tramadol-induced galactorrhea in a female patient [Bondolfi et al. 1997; Hall et al. Inhibitors,research,lifescience,medical 2003]. However, likelihood of either pharmacokinetic or pharmacodynamic interactions with alprazolam was easily eliminated as alprazolam was discontinued long before. The advent

of fluoxetine was the beginning of a new era of safe and effective treatment for patients Inhibitors,research,lifescience,medical with various psychological disorders [Wong et al. 1995; Rossi et al. 2004]. The most commonly reported side effects of fluoxetine include sexual dysfunction, headache and nausea, but, fortunately, only in a small minority of patients and such effects generally disappear after about 2 weeks, although, as with other antidepressants, sexual next dysfunction can persist [Eli Lilly, 1995]. A comprehensive literature review deciphered fluoxetine is well tolerated and rarely associated with serious side effects. Endocrine and reproductive side effects of serotonergic antidepressants (particularly with fluoxetine) are infrequent and uncommon, galactorrhea and amenorrhea is rather rarely mentioned among SSRI-related adverse effects. A MEDLINE search revealed two case reports of fluoxetine-induced galactorrhea. A 71-year-old woman taking estrogen replacement therapy developed galactorrhea after initiation of fluoxetine for depression and was found to have an elevated prolactin level.