Risperidone-induced symptomatic hyperprolactinaemia in adolescents.
Studies performed in adult patients unambiguously demonstrate a marked effect of risperidone on prolactin blood levels, with possible clinical effects related to hyperprolactinemia, such as gynecomastia and galactorrhea. However, the largest study performed in children and adolescents showed a weak effect of risperidone on prolactin concentrations during short-term treatment and a negligible effect during long-term treatment, which was probably because of the relatively low dosages of risperidone used [approximately 0.04 mg/(kg x d)]. Among the 10 psychotic adolescents treated with risperidone in our unit, we had 3 cases of gynecomastia in 3 male patients and 2 cases of galactorrhea in 2 female patients. The prolactin blood levels in these cases and in 3 other patients without apparent prolactin-related side effects were all above the normal range (median, 59 ng/mL; range, 30-123 ng/mL). Thus, risperidone administered to adolescents at doses commonly used for the treatment of psychotic symptoms can strongly increase prolactin levels, with clinical consequences such as gynecomastia and/or galactorrhea. Given that the long-term effects of antipsychotic drug-induced hyperprolactinemia are not well documented, especially regarding osteopenia, infertility, growth, and pubertal delay, risperidone should be administered with caution to children and adolescents.
Holzer
Laurent
L
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Thérapeutique de Jour pour Adolescents, Lausanne, Switzerland. Laurent.Holzer@chuv.ch
Eap
Chin B
CB
D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects*; D016903:Drug Monitoring; D005260:Female; D005687:Galactorrhea / Q000097:blood / Q000209:etiology; D006177:Gynecomastia / Q000097:blood / Q000209:etiology; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000139:chemically induced*; D008297:Male; D011388:Prolactin / Q000097:blood; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy*; D018967:Risperidone / Q000009:adverse effects*
D014150:Antipsychotic Agents; D011388:Prolactin; D018967:Risperidone