Alzheimer’s Delirium and Dementia Q 43
Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following?
A. Increased incidence of dysmenorrhea while taking the drug.
B. Occurrence of incomplete libido due to medication adverse effects.
C. Continuing previous use of contraception during periods of amenorrhea.
D. Instruction that amenorrhea is irreversible.
Correct Answer: C. Continuing previous use of contraception during periods of amenorrhea
Women may experience amenorrhea, which is reversible while taking antipsychotics. Amenorrhea doesn’t indicate cessation of ovulation thus, the client can still be pregnant. Antipsychotic?induced menstrual dysfunction has prevalence rates of approximately 45% for oligomenorrhoea/amenorrhoea and 19% for galactorrhoea (Kinon 2003; Wieck 2003). An illness?related under?function of the hypothalamic?pituitary?gonadal axis in women with schizophrenia may also contribute to menstrual irregularities. This review will focus on amenorrhoea. In an extensive study conducted in India, the prevalence of amenorrhoea in women on risperidone was 60%.
Option A: Other adverse effects can affect women of reproductive age, who have an increased risk of experiencing endocrinological, metabolic and neurological adverse effects from antipsychotic medication (Seeman 2009). Menstrual dysfunction such as amenorrhoea (absence of menstruation) and oligomenorrhea (infrequent or light menstruation) has multiple causes which can include developmental problems with reproductive organs, thyroid disease, stress, excessive weight loss, and hyperprolactinemia (high levels of prolactin production).
Option B: Antipsychotic?induced menstrual dysfunction, if not addressed, not only affects compliance with treatment in women suffering from schizophrenia or similar illnesses but also is a major cause of distress. Amenorrhoea can have physical (for example, bone mineral density changes) and psychological consequences that affect well?being (Haddad 2004).
Option D: Typical antipsychotic medications and some of the novel antipsychotics frequently cause an elevation of plasma prolactin levels. Among the several side reactions related to hyperprolactinemia, are menstrual disorders such as amenorrhea or oligomenorrhea which have not been adequately evaluated.