Antipsychotic-induced hyperprolactinaemia in women: pathophysiology, severity and consequences. Selective literature review.
BACKGROUND
Hyperprolactinaemia has for decades been an inevitable and neglected side-effect of antipsychotic medication. The recent introduction of prolactin-sparing antipsychotic agents makes a re-examination of this problem timely.


OBJECTIVE
To review the literature on antipsychotic-induced hyperprolactinaemia and its consequences.


METHODS
A search was made of the Medline database (1966-2002) for key articles, supplemented by cross-referencing.


RESULTS
During antipsychotic treatment prolactin concentrations can rise to ten times normal levels or above, and existing data indicate that 17-78% of female patients have amenorrhoea with or without galactorrhoea. Survey data, however, suggest that clinicians underestimate the prevalence of these conditions. Long-term consequences of antipsychotic-related hypo-oestrogenism require further research but are likely to include premature bone loss.


CONCLUSIONS
Antipsychotic-induced hyperprolactinaemia should become a focus of interest in the drug treatment of psychiatric patients.
Wieck
A
A
Manchester Mental Health and Social Care Trust, Manchester, UK. angelika.wieck@man.ac.uk
Haddad
P M
PM
D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology; D015519:Bone Density / Q000187:drug effects; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced* / Q000150:complications; D008297:Male; D008599:Menstruation Disturbances / Q000209:etiology; D011388:Prolactin / Q000378:metabolism* / Q000502:physiology; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000523:psychology
D014150:Antipsychotic Agents; D011388:Prolactin