Schizophrenia Q 42
Hormonal effects of the antipsychotic medications include which of the following?
A. Polydipsia and dysmenorrhea
B. Dysmenorrhea and increased vaginal bleeding
C. Retrograde ejaculation and gynecomastia
D. Akinesia and dysphasia
Correct Answer: C. Retrograde ejaculation and gynecomastia
Decreased libido, retrograde ejaculation, and gynecomastia are all hormonal effects that can occur with antipsychotic medications. Reassure the client that the effects can be reversed or that changing medication may be possible. Among women taking conventional antipsychotics, 26% to 78% experienced amenorrhea; some had galactorrhea. There was some evidence that hyperprolactinemia decreases libido, an effect that could cause nonadherence to treatment. In addition, bone loss appeared to be a secondary drug side effect in some studies. Finally, physician surveys indicated that the prevalence and severity of hyperprolactinemia are underestimated.
Option A: Polydipsia is not a hormonal effect. Patients whose signs and symptoms are typical of hyperprolactinemia should be queried closely about their use of antipsychotic medications, and those with long-standing hyperprolactinemia should undergo bone density testing. Hyperprolactinemic effects should be a major consideration in assessing new antipsychotics as they appear on the market.
Option B: Antipsychotic medications are being used increasingly for an expanding array of diagnoses. The stigma associated with antipsychotic medications and the diseases they treat may deter patients from informing healthcare professionals that they are receiving such treatment. Even when clinicians are aware that patients are taking antipsychotics, they may be unaware of the drugs’ effects on prolactin levels and, in turn, prolactin’s effects on ovarian function.
Option D: Akinesia and dysphasia aren’t hormonal effects. Akinesia refers to decreased or absent movement. The term akinesia refers to the inability to perform a clinically perceivable movement. It can present as a delayed response, freezing mid-action, or even total abolition of movement. Akinesia occurs when movement is not perceived either because the amplitude of the movement is small or because the time taken to initiate the reaction is significantly increased. Dysphasia is a condition that affects the ability to produce and understand spoken language. Dysphasia can also cause reading, writing, and gesturing impairments. Dysphasia is caused by brain damage.