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KMID : 0942820110100010015
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Journal of Korean Brain Tumor Society
2011 Volume.10 No. 1 p.15 ~ p.19
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Analysis of Pituitary Lesions in the Patient with Psychiatric Disease
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Kim Seung-Kook
Park Sang-Keun
Hwang Yong-Soon
Shin Jun-Jae
Shin Hyung-Shik
Kim Tae-Hong
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Abstract
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Purpose: The possible toxic effect of chronic neuroleptic drug on the neuroendocrine system has been well documented, and hyperprolatinemia is a common side-effect of antipsychotics. Recently we experienced 12 schizophrenic patients with pituitary lesions. It can be postulated that pituitary dysfunction may cause schizophrenia, or neuroleptic drugs may induce pituitary lesion in the patient with schizophrenia. We analyzed these patients and reviewed related literatures.
Materials and Methods: From October 2007 to April 2009, ten patients who had been treated at department of psychiatry under the diagnosis of schizophrenia (6 patients) and other psychiatric diseases (6 patients) were enrolled in this study. The pituitary lesions were detected by MRI and consulted to neurosurgical department. Various possible clinical information, medication history, radiological finding and result of neurosurgical management were analyzed.
Result: Radiological findings of twelve patients with pituitary lesions were definite pituitary tumors in 6, cystic lesions in 3 and suspicious tumorous lesions in 3 patients. Medicated drugs at psychiatric department were risperidone, clozapine and other antidepressants. We had operated for 4 patients who had schizophrenia concomitant with definite pituitary tumors. After surgery psychological symptoms of these patients were improved in spite of minimized neuroleptic drugs. The pituitary lesions in the none operated patients were diminished or unchanged during the suitable observation period.
Conclusion: Neuroleptic drug may act as toxic effect on pituitary gland by blocking predominantly dopamine receptors of the D2 class as well as other receptors to varying degrees. We experienced 10 psychiatric patients with pituitary lesions. It may be considered that neuroleptic drugs enhance pituitary lesions, or high prolactin level aggravates schizophrenic symptoms.
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KEYWORD
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Pituitary tumor, Schizophrenia, Hyperprolactinemia
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