TABLE 51.3 PARTIAL LIST OF DRUGS THAT CAN CAUSE HYPERPROLACTINEMIA AND/OR GALACTORRHEA Antipsychotic and antidepressant agents Phenothiazines (e.g., chlorpromazine [Thorazine], clomipramine [Anafranil], fluphenazine [Prolixin], prochlorperazine [Compazine], thioridazine [Mellaril]) Haloperidol (Haldol) Pimozide (Orap) Risperidone (Risperdal) Thiothixene (Navane) Drugs used to treat gastrointestinal disorders Cimetidine (Tagamet) Metoclopramide (Reglan) Antihypertensive agents Methyldopa (Aldomet) Reserpine (Hydromox, Serpasil, others) Verapamil (Calan, Isoptin) Opiates Codeine Morphine The administration of exogenous progestin is often used by specialists as an in vivo test of ovarian and endometrial function for oligomenorrheic patients with the supposition that “withdraw flow,” if it appears, provides the patient and her physician with tangible evidence of the basic integrity of the organs and the hypothalamic–pituitary axis For diagnosis in adolescents, however, laboratory investigation is much preferable to progestin administration Keep in mind, however, that nearly all nonpregnant adolescents with oligomenorrhea will have a withdrawal bleed; laboratory investigation may still be recommended Appropriate follow-up will be essential ACKNOWLEDGMENTS We would like to thank Dr Jennifer H Chuang and Dr Jan Paradise for their work on earlier editions of this chapter