finding that would explain amenorrhea was not detected by the obstetrician. The patient’s prolactin level was determined as 45.6 ng/mL (reference range, 5.18Y 26.53 ng/mL), and it was thought to be related to the use of duloxetine. The dosage was reduced to 30 mg/d, and the prolactin level was measured after 1 week and found as 23 ng/mL; 10 days later, menstruation was detected. The patient’s treatment with a dosage of 30 mg/d duloxetine continued for 5 months; amenorrhea complaints did not reiterate, and prolactin levels remained normal. Recently reviewed Beck Depres- sion Inventory score was found as 12, and Beck Anxiety Inventory score was 8. CASE 2 A 47-year-old woman presented with demoralization, reluctance, fatigue, headache, and complaints of excessive sleepiness. There were complaints for many years. She had used various antidepressant drugs over the years, and for the last 5 years, she has been using escitalopram 20 mg/d and quetiapine 50 mg/d. Her history shows no alcohol and drug use, continuous drug use, or organic disorders. She was not sex- ually active. She had a regular menstrual period, and follow-up was being done by gynecologists. Beck Depression Inventory score was found as 38, and Beck Anxiety Scale score was found to be 22. The pa- tient was treated with a dosage of 30 mg/d due to the diagnosis of major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; the patient’s depressive symptoms at the end of the first month fell, but delayed menstruation was seen. The physical examination result and labora- tory values for thyroid stimulating hormone, urea, creatinine, glucose, urea, creatinine, aspartate transaminase, alanine transami- nase, and electrolyte were normal. She did not use oral contraceptives and was not pregnant. The patient’s prolactin level was determined as 57.6 ng/mL (reference range, 5.18Y26.53 ng/mL). The patient was re- ferred by neurology and gynecology. The result of cranial MRI was normal. The pathologic finding that would explain amen- orrhea was not detected by the obstetrician, and the patient was started on dopamine re- ceptor agonist cabergoline 0.5 mg/d twice a week. The prolactin level was measured 1 month later and found as 26.8 ng/mL; menstrual period was detected 15 days later. With normalization of the patient, prolactin cabergoline treatment was dis- continued by the obstetrician. Duloxetine therapy was stopped, and the treatment with venlafaxine 37.5 mg was started; the patient was then treated with venlafaxine 75 mg/d; amenorrhea complaints were not reiterated, and prolactin levels remained normal. The last Beck Depression Inven- tory score was 14, and Beck Anxiety In- ventory score was 9. 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A Case of Late-Onset Angioedema Associated With Clozapine and Redevelopment of Angioedema With Olanzapine To the Editors: A ngioedema is a rare but potentially life- threatening adverse effect of antipsy- chotics such as risperidone, 1Y4 olanzapine, 5 clozapine, 6 ziprasidone, 7,8 droperidol, 9,10 and chlorpromazine. 11,12 Nonsteroid anti- inflammatory drugs, angiotensin-converting enzyme inhibitors (ACEIs), penicillin, and neuromuscular blockers are the most com- mon medications held responsible for angioedema. 13 Angioedema is the swell- ing of deep dermal and subcutaneous tissues that occurs on the face, tongue, extremities, genitals, and rarely larynx. 7 The late-onset angioedema is a rare clin- ical condition that occurs months or years, after which is more likely reported with ACEIs. 14Y16 Here we report a female pa- tient who developed late-onset angioedema after treatment with clozapine after 5 years and redevelopment of angioedema with Journal of Clinical Psychopharmacology & Volume 34, Number 4, August 2014 Letters to the Editors * 2014 Lippincott Williams & Wilkins www.psychopharmacology.com 523 Copyright © 2014 Lippincott Williams & Wilkins. 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