Clinical implications of antipsychotic-induced hyperprolactinemia in patients with schizophrenia spectrum or bipolar spectrum disorders: recent developments and current perspectives.
Hyperprolactinemia is increasingly studied as a frequent and potentially important consequence of antipsychotic medication treatment. Some individuals presenting with hyperprolactinemia remain asymptomatic, but others may exhibit a wide range of clinical symptoms resulting from either the direct effects of prolactin on body tissues (galactorrhea, gynecomastia) or endocrine-related secondary effects (sexual and reproductive dysfunction in the short term, and possibly the risk of tumorigenesis and osteoporosis in the longer term). Short-term side effects may negatively impact medication compliance, and long-term effects have the potential for serious health consequences. Antipsychotic medications have differing propensities to cause prolactin elevation. The first-generation antipsychotics, as well as the second-generation antipsychotic risperidone and its active metabolite paliperidone, have been shown to cause marked and sustained elevations in prolactin levels, whereas others of the second-generation antipsychotics appear to have little or no effect on prolactin levels or may decrease prolactin. A comprehensive overview of antipsychotics and hyperprolactinemia is presented together with a review of emerging evidence about the short- and long-term health risks of hyperprolactinemia.
Byerly
Matthew
M
Department of Psychiatry, University of Texas Southwestern Medical Center, 6363 Forest Park Road, Dallas, TX 75235, USA. Matt.Byerly@UTSouthwestern.edu
Suppes
Trisha
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Tran
Quynh-Van
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Baker
Ross A
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D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced*; D015201:Meta-Analysis as Topic; D008954:Models, Biological; D011600:Psychopharmacology / Q000639:trends; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents