Hormonal side effects of antidepressants are infrequent, and galactorrhea is seldom mentioned among tricyclic antidepressant (TCA) and selective serotonin reuptake inhibitor (SSRI)-related side effects. Antidepressants can directly stimulate postsynaptic 5-HT receptors in the hypothalamus or indirectly inhibit the tuberoinfundibular dopaminergic neurons through 5-HT, which may increase prolactin levels and later cause galactorrhea. We describe a case of euprolactinemic galactorrhea in a postmenopausal woman, induced by imipramine and escitalopram. This report highlights the presence of unidentified novel mechanisms of antidepressant-induced galactorrhea and other possible contributors.
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