DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.038

Pages: 2345-2347

Objective: To investigate the causal relationship between sertraline use and hyperprolactinemia through a clinical case. Methods: Patient Z., a 37-year-old woman, was diagnosed with major depressive disorder and started on sertraline at an initial dose of 50 mg/day. After five months of treatment, she developed galactorrhea and menstrual delay. Laboratory tests confirmed hyperprolactinemia, with a prolactin level of 74 µg/L. Sertraline was tapered and discontinued, then replaced with escitalopram. Symptoms rapidly resolved, and prolactin levels normalized within three weeks. Results: Substituting sertraline with escitalopram led to remission of depressive symptoms and normalization of prolactin levels, with no recurrence of hyperprolactinemia or other side effects. Discussion: Hyperprolactinemia is a rare but documented side effect of SSRIs such as sertraline and can cause diverse symptoms affecting quality of life. Possible underlying mechanisms include inhibition of dopaminergic activity. Clinical management often involves dose reduction or switching medications. In this case, escitalopram effectively resolved hyperprolactinemia while maintaining antidepressant efficacy. Women may be particularly vulnerable to SSRI side effects due to hormonal and metabolic factors. Conclusion: Early detection of SSRI side effects, including hyperprolactinemia, requires continuous clinician training and careful symptom evaluation. Further research into etiological mechanisms and pharmacogenetic strategies may help personalize treatment. A holistic, multidisciplinary approach is essential in managing such complications