Brief Answer:
Abnormal prolactin levels are probably due to anti-psychotic medicines

Detailed Answer:
Hello thanks for choosing HEALTH CARE MAGIC for your health related queries

I have read your query and I can understand your concern. You had some issues with professors at college six years back and developed psychotic episode. The doctors prescribed Olanzapine in high doses at that time and which resulted in improvement in symptoms but also resulted in weight gain. You have developed HIV after some time due to unprotected intercourse. You are currently on Amisulpiride 200 mg and Desvenlafaxine 50 mg per day. You got your tests done and levels of Testosterone and Prolactin along with Lipid profile came in abnormal ranges.

Now coming to discussion-

Levels of Prolactin increases with common anti-psychotic medicines. You are taking Amisulpiride and the drug is known to increase weight and hyperprolactinemia. I am afraid the levels of PROLACTIN are not increased due to some tumour in brain. Yes antipsychotics may increase risk of Prolactinoma which is a benign tumourous growth of brain. (I want to know whether you have been diagnosed with some brain tumour or not?)

High prolactin levels affect levels of testosterone. Prolactin results in low testosterone levels. So the reason of your weight gain, abnormal lipid profile and abnormal gonadal hormonal levels is your intake of AMISULPIRIDE.

Then what can be done?

In such case you can discuss with your psychiatrist to prescribe some medicines that is relatively safer. Drugs like ARIPIPRAZOLE can be given in your case. ARIPIPRAZOLE is having minimal risk for weight gain, metabolic syndrome and less effect on gonadal hormones. This will result in improvement of your metabolic parameters and will not make you sick.

You have been given Cabergoline and the drug helps to reduce the size of prolactinoma and improves the concentration of prolactin. This drug will help to improve your levels and should benefit you. As per my opinion you should take this drug and tumour growth will not be fast on taking this drug.

Testosterone will improve your levels of hormone but this may take some time. So there is no need to fear as your levels will improve in some time. The drug will result in improvement in fatty liver also.

Thanks, hope this helps you. Don't hesitate to ask again in follow up question if you have more doubts.

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Brief Answer:
Rosuvas is a safe drug and has few side effects

Detailed Answer:
Hello, thanks for asking a follow up question

Rosuvas is Rosuvastatin and the drug is used in patients with high cholesterol levels. Over all at this dose the drug is safe to use and should not cause serious side effects at 20 mg doses. The drug can cause restlessness, insomnia, depression, constipation, epigastric discomfort, confusion, nausea as side effects. As per my opinion the drug at this dose is safe and you can take the drug without any worries as per your prescription.

Aripiprazole is available as ABILIFY, Arip MT, XXXXXXX Asprito etc brands. You can discuss with your psychiatrist for prescription of the drug.

Use proper protection methods while doing intercourse with your wife. Try to be gentle while doing intercourse. The reasons of pain during intercourse in your wife are probably due to psychologic and emotional reactions. She might have developed fear and this can be causing contraction of pelvic muscles which could cause pain. Get the HIV status of your wife and son checked to rule out infection. Try to talk with her about the illness and explain her that the illness don't pass by mere touching someone or by sharing same house. Try to gain her confidence and she will improve.

Thanks, hope this helps you.

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Brief Answer:
If Aripiprazole didn't work then Asenapine is other option

Detailed Answer:
Hello again

Aspirto is metabolically safer as compared to other antipsychotic drugs. If the drug didnt work in your case then other options are newer drugs like Asenapine, Iloperidone. Asenapine is new drug and it causes minimal weight gain. It doesn't cause prolactin increase so will be safe to use. The drug has comparable efficacy to other antipsychotic drugs. You can discuss with your psychiatrist for these drugs.

If her status is negative then I would advise you to use barrier methods regularly, don't kiss her for long periods of time, avoid any thing that may cause exchange of direct body fluids. Try to protect her from getting infection.

Thanks.

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Brief Answer:
Yes topiramate can help you in weight reduction

Detailed Answer:
Hello thanks for asking a follow up question

Yes topiramate can be utilised for weight loss in your case. The drug will also help in stabilising your mood. No the drug will not cause harm to use. It is safe drug and don't cause any serious side effect at prescribed doses.

Fear of brain haemorrhage or vein rupture is due to anxiety only. You are already taking Desvenlafaxine and the drug will reduce anxiety. Relaxation exercises will help to increase confidence and can help you in reducing anxiety. Breathing exercise, yoga, meditation etc are other non medicinal methods to reduce this fear.

No if you have been tested positive for HIV then I will strongly advise you to not to plan for pregnancy in your wife. This will pose danger to her and she will develop infection. Use protection methods during intercourse. Please don't think about making her pregnant.

Sapheris, Sycrest, Asena etc are common brands for drug Asenapine.


Thanks, hope this helps you. If you have more doubts you can ask again.

Take care and wish you a good health.

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