Although olanzapine typically does not cause problematic elevation of prolactin levels, olanzapine is viewed as causative in this instance because galactorrhea and akathisia both began at its initiation and ceased with the substitution of quetiapine, which has weaker dopamine binding (1). Minor prolactin elevation was observed, although its level was still within the normal range. Euprolactinemic galactorrhea has been associated with thyroid abnormalities, but the patient’s level of thyroid-stimulating hormone was normal (2). The reason galactorrhea occurred is unclear, but it may have been due to structural damage and greater sensitivity to prolactin resulting from the patient’s anoxia at birth. The akathisia may also have been a product of greater sensitivity to dopamine blocking.