Gynecomastia with risperidone-fluoxetine combination

Pharmacopsychiatry. 1999 Jan;32(1):41. doi: 10.1055/s-2007-979187.


Gynecomastia (breast enlargement) is a side effect of neuroleptic antipsychotic drugs, related to prolactin elevation caused by dopamine D2 receptor blockade (Richelson, 1996). The atypical antipsychotic risperidone is less likely to cause gynecomastia at low doses (Casey, 1996). It can cause a dose-dependent increase in serum prolactin concentration (Peuskens, 1995), by blocking dopamine D2 receptors (Richelson, 1996). I would like to describe a patient who did not have gynecomastia with risperidone at a dose of 3 mg/day, but had it when risperidone, at a dose of 0.5 mg/day, was combined with fluoxetine. A MEDLINE search failed to find any reports about such an interaction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Drug Combinations
  • Fluoxetine / adverse effects*
  • Fluoxetine / therapeutic use
  • Gynecomastia / chemically induced*
  • Gynecomastia / pathology
  • Humans
  • Male
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / complications
  • Psychotic Disorders / drug therapy
  • Risperidone / adverse effects*
  • Risperidone / therapeutic use
  • Selective Serotonin Reuptake Inhibitors / adverse effects*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use


  • Antipsychotic Agents
  • Drug Combinations
  • Serotonin Uptake Inhibitors
  • Fluoxetine
  • Risperidone