252 ARATIRMA Makalenin geli tarihi: 11.12.2011, Yayna kabul tarihi: 04.12.2012 Seici Serotonin Gerialm nhibitrleri ve Galaktore: Ayn Olgu zerinden Sertralin ve Sitalopramn Karlatrlmas Selective Serotonin Reuptake Inhibitors and Galactorrhea: A Comparison of Sertraline and Citalopram Based on a Case Report Sevilay zcan 1 , Lut Tamam 2 , Aye Soydan 1 1 Uz.Dr., Adana Ruh Sal ve Hastalklar Hastanesi, 2 Prof.Dr., ˙ukurova niversitesi Tp Fakültesi Psikiyatri Anabilim Dal, Adana SUMMARY Hyperprolactinemia and galactorrhea are very common in psychiatric patients because of the mechanism of action of antipsychotic drugs on dopamine receptors. This side effect could also appear during antidepressant treatment. Hyperprolactinemia has been reported to occur as a side effect during treatment with different types of antidepressants including tricyclic antidepres- sants, selective noradrenaline reuptake inhibitors, selec- tive serotonin reuptake inhibitors (SSRI). In some case reports this side effect has been linked with the dosage of the medication used. Besides, galactorrhea due to SSRI usage has been proposed to be a result of direct stimulation of serotonin to prolactin release or indirect effect of serotonin as dopamine antagonist. In this paper we described case that has been using 50 mg ser- tralin per day for the treatment of her current mixed anx- iety and depressive disorder episode. During her treat- ment, she complained about galactorrhea and prolactin elevation. She recovered from this adverse effect just after cessation of the sertralin. One week later she has been introduced another SSRI, citalopram at a dose of 20 mg per day which resulted in total remission of her symptoms. In this case, we discussed two different med- ications which are believed to have same mechanism of action for depression globally, but display different effects on prolactin levels due to diversity of their other receptor interactions. Physicians should be aware of sub- tle differences in between SSRIs leading to different side effects and prescribe their drugs to the patients accor- dingly. Key Words: galactorrhea, sertralin, citalopram, prolak- tin. ZET Psikiyatrik hastalarda prolaktin art ve galaktore daha ok dopamin reseptrleri üzerinden etki etmesi nedeniyle antipsikotik ilalarn yan etkisi olarak olduka sk karmza kmaktadr. Nadiren de olsa antidepresan ilalarla ortaya ktna dair olgu bildirimleri bulunmak- ta olup trisiklik antidepresanlar, serotonin noradrenalin gerialm inhibitrleri ve seici serotonin gerialm inhibitrleri (SSRI) de dahil bir ok antidepresanla bildirilmitir. Bu yan etki baz olgularda dozla ili- kilendirilmitir. SSRI kullanmnn yol at galaktore tüm SSRI’larn ortak zellii olarak serotoninin prolaktin üze- rine direkt etkisi ile ya da dolayl olarak serotoninin dopamin antagonizmas ile aklanmaya allmtr. Bu yazda kark anksiyete depresif bozukluk tans ile sert- ralin 50 mg/gün tedavisi kullanmakta iken prolaktin düzeylerinde yükselme ve galaktore yaknmas ile bavu- ran ve ilacn kesilmesi ile düzelen ve bir hafta sonra balanan sitalopram 20 mg/gün tedavisi sürecinde bu yaknmas tamamen ortadan kalkan bir olgu tanmladk. Bu olguda ayn mekanizma ile etki ettiine inanlan iki farkl ilac bu yan etki balamnda birbirinden ayran etki mekanizmalar kapsamnda tartlmtr. Anahtar Szcükler: galaktore, sertralin, sitalopram, pro- laktin. (Klinik Psikiyatri 2012;15:252-254)