Dose-related depressive symptoms and suicidal ideation during cabergoline therapy in an adolescent with macroprolactinoma.
- 1Primary Health Care, Ministry of Health, Muscat 100, Oman.
- 2Family Medicine and Public Health, Sultan Qaboos University Hospital, University Medical City, Muscat 123, Oman.
- 3Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman.
Abstract
Cabergoline is the preferred medical treatment for prolactinomas in children and adolescents because of its efficacy in reducing prolactin concentrations and tumor size. Although dopamine agonists are generally well tolerated, neuropsychiatric adverse effects have been reported, with depressive symptoms and suicidal ideation less frequently described. We report a 15-year-old girl with macroprolactinoma who developed low mood, emotional dysregulation, crying spells, reduced appetite, sleep-wake disturbance, loss of interest in previously enjoyable activities, and passive suicidal thoughts after cabergoline was increased to 1 mg twice weekly. She had no previous psychiatric history, major psychosocial stressor, manic symptoms, or psychotic features. Psychiatric assessment identified moderate depressive symptoms, with a Patient Health Questionnaire-9 score of 11. Cabergoline was reduced to 0.75 mg twice weekly because of the close temporal relationship between dose escalation and symptom onset. Her psychiatric symptoms almost completely resolved within a few days, while prolactin remained controlled. The temporal association, apparent dose relationship, and rapid improvement following dose reduction suggest a cabergoline-associated neuropsychiatric adverse reaction. Clinicians should monitor mood and suicidal ideation during dopamine agonist therapy, particularly after dose escalation and in adolescents.
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BibTeX
@article{malik2026doserelated,
title = {{Dose-related depressive symptoms and suicidal ideation during cabergoline therapy in an adolescent with macroprolactinoma.}},
author = {Saniha Malik and Amira Al Harrasi and Maryam Issa Al Kiyumi and Maisa Hamed Al Kiyumi},
journal = {JCEM case reports},
year = {2026},
month = nov,
doi = {10.1210/jcemcr/luag351},
url = {https://europepmc.org/article/MED/42996583},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dose-related depressive symptoms and suicidal ideation during cabergoline therapy in an adolescent with macroprolactinoma.
AU - Saniha Malik
AU - Amira Al Harrasi
AU - Maryam Issa Al Kiyumi
AU - Maisa Hamed Al Kiyumi
PY - 2026
DA - 2026/11/06
JO - JCEM case reports
DO - 10.1210/jcemcr/luag351
UR - https://europepmc.org/article/MED/42996583
AB - Cabergoline is the preferred medical treatment for prolactinomas in children and adolescents because of its efficacy in reducing prolactin concentrations and tumor size. Although dopamine agonists are generally well tolerated, neuropsychiatric adverse effects have been reported, with depressive symptoms and suicidal ideation less frequently described. We report a 15-year-old girl with macroprolactinoma who developed low mood, emotional dysregulation, crying spells, reduced appetite, sleep-wake disturbance, loss of interest in previously enjoyable activities, and passive suicidal thoughts after cabergoline was increased to 1 mg twice weekly. She had no previous psychiatric history, major psychosocial stressor, manic symptoms, or psychotic features. Psychiatric assessment identified moderate depressive symptoms, with a Patient Health Questionnaire-9 score of 11. Cabergoline was reduced to 0.75 mg twice weekly because of the close temporal relationship between dose escalation and symptom onset. Her psychiatric symptoms almost completely resolved within a few days, while prolactin remained controlled. The temporal association, apparent dose relationship, and rapid improvement following dose reduction suggest a cabergoline-associated neuropsychiatric adverse reaction. Clinicians should monitor mood and suicidal ideation during dopamine agonist therapy, particularly after dose escalation and in adolescents.
SN - 2755-1520
ER -