Sulpiride-Induced Severe Hyperprolactinemia in an IBS Patient: A Case Report From Saudi Arabia

Introduction: This case report highlights a significant instance of severe hyperprolactinemia induced by Sulpiride in a patient with irritable bowel syndrome. While Sulpiride is sometimes used off-label for gastrointestinal issues due to its prokinetic and anxiolytic effects, its potential to markedly raise serum prolactin levels is often overlooked, especially in the Middle Eastern population. This report adds valuable regional insights to the limited global literature on this adverse drug reaction. Case Description: A 38-year-old female from Saudi Arabia with irritable bowel syndrome presented with galactorrhea, irregular menstrual cycles, and breast tenderness after 1 month of taking sulpiride 50 mg daily for gastrointestinal issues. She reported no prior endocrinology or gynecology problems. Discussion: Laboratory investigations showed a marked elevation in serum prolactin levels, exceeding 200 ng/mL. Imaging examinations verified the absence of any pituitary tumor. Sulpiride was discontinued, and after 2 weeks, a follow-up assessment showed that prolactin levels had returned to normal, and the symptoms had resolved. Conclusion: Monitoring hyperprolactinemia is critical in patients receiving Sulpiride, especially when prescribed for nonpsychiatric cases like irritable bowel syndrome. Regular checks and cautious off-label prescribing are crucial for prompt identification and discontinuation of the medication to prevent long-term endocrine issues.