NEUROBEHAVIORAL SYNDROME INDUCED BY H-2-RECEPTOR BLOCKER WITHDRAWAL -POSSIBLE ROLE OF PROLACTIN

Cimetidine and ranitine are histamine H-2-receptor blockers widely use d for the treatment of gastric hypersecretion and duodenal pathologies . They are known to induce hyperprolactinemia in humans. Forty-six pat ients treated with cimetidine or ranitidine who were exhibiting a neur obehavioral syndrome after withdrawal of the drugs were selected. This syndrome was associated with a drop in plasma prolactin levels. The s ymptoms of this syndrome were greatly improved by restoration of treat ment with the same drugs and reappeared when the treatment was again s uspended. This syndrome was inhibited in 36 patients by administration of domperidone (30 mg/day), a drug inducing hyperprolactinemia withou t crossing the blood-brain barrier, as compared with 10 control patien ts treated with placebo. These results suggest that the drop in prolac tin levels occurring when cimetidine and ranitidine are suspended may contribute to the development of this syndrome. Also, the withdrawal o f H-2 receptor blockers could be included among the possible causes of some neurotic syndromes.