Risperdal & Gynecomastia

Side effects of the antipsychotic medication Risperdal (generic: risperidone) may include gynecomastia, an embarrassing and emotionally damaging condition characterized by abnormal breast tissue growth in boys and young men. Breast development may occur as a result of Risperdal’s dopamine-blocking action, which can significantly increase levels of prolactin, a hormone released by the pituitary gland. In women, prolactin stimulates breast development and the production of breast milk. In men, elevated levels of prolactin can prompt similar processes, resulting in gynecomastia and galactorrhea (abnormal lactation). In severe cases, male Risperdal users have developed large, D-cup sized breasts.

Risperdal Gynecomastia Studies

Studies began linking Risperdal use to gynecomastia as far back as 1999. Since then, a considerable amount of research has confirmed this link. A 2006 study published in the Journal of Clinical Psychopharmacology found that:

“Risperidone administered to adolescents at doses commonly used for the treatment of psychotic symptoms can strongly increase prolactin levels, with clinical consequences such as gynecomastia … risperidone should be administered with caution to children and adolescents.”

Another study published in the Journal of Child and Adolescent Psychopharmacology in September 2015 indicated that young men who take Risperdal may be 5x more likely to develop excess breast tissue compared to non-users. This risk also increases for older men, who may be as much as 69% more likely to develop gynecomastia compared to men who do not take antipsychotic medications.

Symptoms

Signs and symptoms of gynecomastia include:

• Swollen breast gland tissue
• Breast pain / tenderness
• Nipple discharge in one or both breasts

Effects of Gynecomastia

Gynecomastia is not typically a threat to physical health; however, it can cause a great deal of emotional and psychological damage to boys and young men with the condition. In April 2013, a research team led by Dr. Brian I. Labow at Boston Children’s Hospital conducted a series of psychological tests on 47 teenage boys with gynecomastia and compared the results with a group of boys without the condition.

The gynecomastia group scored lower for general health, social functioning, self-esteem, mental health and eating behaviors. These effects were similar in test subjects with varying degrees of gynecomastia, which suggests that merely having the condition, no matter how severe, can inflict severe psychological damage.

Additionally, patients who require breast reduction surgery often experience severe physical pain and trauma. Complications associated with the procedure include prominent scarring, blood clots, infection, anesthesia reactions, breast shape irregularities and nerve damage.

Risk Factors

In addition to taking Risperdal, other factors that may increase your risk of developing gynecomastia include:

• Adolescence
• Older age
• Use of anabolic steroids or androgens to enhance athletic performance
• Pre-existing health conditions including liver and kidney disease, thyroid dysfunction, hormonally active tumors and Klinefelter syndrome

Treatment

Fortunately, there are a number of options available for Risperdal users who develop gynecomastia. These include:

• Breast Reduction Surgery – Male breast reduction surgery is the most common treatment for gynecomastia. This procedure, also known as reduction mammaplasty, involves removing excess fat and glandular tissue to restore a more masculine contour to the man’s chest. Ideal candidates for breast reduction surgery include patients who are physically and emotionally stable, within their ideal body weight, have good skin elasticity and are over the age of 18.  

• Liposuction – Many cosmetic surgeons are now able to treat gynecomastia using liposuction. This procedure involves removing excess fat and/or glandular tissue though a small incision on each side of the chest. This helps sculpt a new chest contour that looks natural to the patient’s body.

• Tissue Excision – Patients with severe cases of gynecomastia, as well as those with stretched or sagging skin, may require surgical tissue excision. This procedure allows the surgeon to remove a greater amount of glandular tissue and/or skin that cannot be removed with liposuction alone. The location and length of the incisions depends on the extent of surgery required, but are typically located around the edge of the areola or within the chest’s natural creases.

Prevention

If you are a Risperdal user who is concerned about developing gynecomastia, talk to your doctor about your switching to another medication with fewer side effects. However, you should never switch or stop taking a medication without talking to your doctor first. Other things you can do to prevent gynecomastia include avoiding alcohol, illegal drugs and steroids.