Effects of olanzapine on prolactin levels of female patients with schizophrenia treated with risperidone.
BACKGROUND
This study was conducted to prospectively examine the effect of switching from risperidone to olanzapine on female schizophrenia patients who experienced menstrual disturbances, galactorrhea, and/or sexual dysfunction.


METHODS
Twenty female patients with DSM-IV schizophrenia who were taking risperidone and were suffering from menstrual disturbances, galactorrhea, and/or sexual dysfunction were enrolled. Patients were switched from risperidone to olanzapine over a 2-week period, then treated with olanzapine for 8 additional weeks. The serum prolactin concentrations were examined every 2 weeks. The Positive and Negative Syndrome Scale (PANSS), Abnormal Involuntary Movement Scale (AIMS), Simpson-Angus Scale for Extrapyramidal Symptoms (SAS), and questions from the Dickson-Glazer Sexual Functioning Scale were administered to evaluate efficacy, extrapyramidal side effects, and sexual and reproductive functioning at baseline and the endpoint of 10 weeks.


RESULTS
Serum prolactin levels decreased significantly (p < .01) following the switch from risperidone to olanzapine. Scores of PANSS, AIMS, and SAS at the endpoint were also significantly decreased (p < .01) compared to those of baseline. Patients experienced improvements in menstrual functioning and perceptions of sexual side effects.


CONCLUSIONS
Olanzapine reversed hyperprolactinemia in risperidone-treated female schizophrenic patients. This was associated with a decrease in amenorrhea, improved cycle regularity, and a decrease in sexual side effects that the women attributed to antipsychotic medication. This study suggests that switching to olanzapine is a safe and effective alternative method for patients with antipsychotic-induced hyperprolactinemia associated sexual and/or reproductive dysfunction. Long-term follow-up studies are warranted, with particular attention to the course of sexual and reproductive dysfunction.
Kim
Kwang-Soo
KS
Department of Psychiatry, St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul.
Pae
Chi-Un
CU
Chae
Jeong-Ho
JH
Bahk
Won-Myong
WM
Jun
Tae-Youn
TY
Kim
Dai-Jin
DJ
Dickson
Ruth A
RA
D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced / Q000517:prevention & control; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000517:prevention & control; D001569:Benzodiazepines; D005260:Female; D005687:Galactorrhea / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced* / Q000517:prevention & control; D008599:Menstruation Disturbances / Q000139:chemically induced / Q000517:prevention & control; D008875:Middle Aged; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011388:Prolactin / Q000097:blood*; D011446:Prospective Studies; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced / Q000517:prevention & control; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D011388:Prolactin; D018967:Risperidone; D000077152:Olanzapine