PRL and hyperprolactinemia: Similarly, atypical antidepressants such as bupropion and mirtazapine demonstrate variable effects on prolactin: bupropion is generally associated with decreased prolactin through dopaminergic mechanisms, though paradoxical hyperprolactinemia has been reported [21,33], while mirtazapine has been implicated in galactorrhea with elevated prolactin, likely via serotonergic pathways [32].