Atypical antipsychotics and pituitary neoplasms in the WHO database.
Amisulpride and risperidone are potent dopamine D2 receptor blocking atypical antipsychotics that can cause hyperprolactinemia. Preclinical evidence shows that chronic administration of antipsychotics can cause pituitary adenomas in female mice. To investigate the clinical relevance in this finding, reports of pituitary neoplasms in the WHO adverse drug reaction (ADR) database were reviewed. Amisulpride and risperidone [corrected] had among the highest Information Component (IC) scores for benign pituitary neoplasm; amisulpride (IC = 3.31, IC025 = 1.83, 5 reports) and risperidone (IC = 4.03, IC025 = 3.33, 19 reports), and not otherwise specified (NOS) pituitary neoplasm: amisulpride (IC = 2.69, IC025 = 0.70, 3 reports) and risperidone (IC = 4.49, IC025 = 3.86, 23 reports). We conclude that there is a need for prospective studies to confirm causality and suggest that clinicians, until then, would consider a pituitary adenoma in patients experiencing severe hyperprolactinemia or associated symptoms when receiving potent D2 antagonists [corrected]
Doraiswamy
P Murali
PM
Department of Psychiatry and the Department of Medicine at Duke University Medical Center, DUMC 3018, Durham, NC 27514, USA. dorai001@mc.duke.edu
Schott
Gisela
G
Star
Kristina
K
Edwards
Ralph
R
Mueller-Oerlinghausen
Bruno
B
D000236:Adenoma / Q000139:chemically induced* / Q000453:epidemiology; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015984:Causality; D005260:Female; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D012306:Risk; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D013469:Sulpiride / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014944:World Health Organization
D014150:Antipsychotic Agents; D013469:Sulpiride; D000077582:Amisulpride; D018967:Risperidone