Switch to quetiapine in antipsychotic agent-related hyperprolactinemia.
Novel antipsychotics (clozapine, risperidone, olanzapine, quetiapine) are effective in treating psychotic symptoms, also in neurological disease. Hyperprolactinemia is a side effect related to antipsychotics that can cause galactorrhea, gynecomastia, amenorrhea, anovulation, impaired spermatogenesis, decreased libido and sexual arousal, impotence, and anorgasmia, consequent to removal of tonic dopaminergic inhibition of prolactin secretion via hypothalamic dopaminergic receptor blockade in the tuberoinfundibolar tract. Hyperprolactinemia occurs more frequently during treatment with risperidone and olanzapine compared with clozapine and quetiapine. The therapeutic algorithm to antipsychotic-relatedhyperprolactinemia is the following: reduction in antipsychotic dose, addition of cabergoline, bromocriptine, amantadine, and/or switch to another antipsychotic. We propose switching to quetiapine in symptomatic hyperprolactinemia related to antipsychotics and describe five cases.
Keller
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R
Dipartimento di Salute Mentale, Ospedale Amedeo di Savoia, Corso Svizzera 164, I-10149 Turin, Italy.
Mongini
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F
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015283:Citalopram / Q000031:analogs & derivatives / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000032:analysis / Q000097:blood / Q000187:drug effects; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D015283:Citalopram; D000069348:Quetiapine Fumarate; D011388:Prolactin; D018967:Risperidone