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Etiology of Hyperprolactinemia



I. Physiologic hypersecretion
    Pregnancy
    Lactation
    Chest wall stimulation
    Sleep
    Stress
II. Hypothalamic–pituitary stalk damage
    Tumors
        Craniopharyngioma
        Suprasellar pituitary mass
        Meningioma
        Dysgerminoma
        Metastases
    Empty sella
    Lymphocytic hypophysitis
    Adenoma with stalk compression
    Granulomas
    Rathke's cyst
    Irradiation
    Trauma
        Pituitary stalk section
        Suprasellar surgery
III. Pituitary hypersecretion
    Prolactinoma
    Acromegaly
IV. Systemic disorders
    Chronic renal failure
    Hypothyroidism
    Cirrhosis
    Pseudocyesis
    Epileptic seizures
V. Drug-induced hypersecretion
    Dopamine receptor blockers
        Atypical antipsychotics: risperidone
        Phenothiazines: chlorpromazine, perphenazine
        Butyrophenones: haloperidol
        Thioxanthenes
        Metoclopramide
    Dopamine synthesis inhibitors
        alpha-Methyldopa
    Catecholamine depletors
        Reserpine
    Opiates
    H2 antagonists
        Cimetidine, ranitidine
    Imipramines
        Amitriptyline, amoxapine
    Serotonin reuptake inhibitors
        Fluoxetine
    Calcium channel blockers
        Verapamil
        Estrogens
        TRH

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