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Antipsychotic-induced hyperprolactinemia — USMLE Step 3 MCQ

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ModerateOB/GYN (prenatal care, contraception, screening)Antipsychotic-induced hyperprolactinemiaUSMLE Step 3

A 24-year-old woman has amenorrhea, galactorrhea, and infertility. She takes risperidone for schizophrenia. Pregnancy test is negative and TSH is normal. Prolactin is elevated. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: D — Dopamine D2 receptor blockade disinhibiting prolactin release

Dopamine inhibits prolactin; D2 blockade by antipsychotics can cause hyperprolactinemia with galactorrhea and amenorrhea.

Reference: APA schizophrenia guideline; endocrine pharmacology