Prolactin awareness: an essential consideration for physical health in schizophrenia.
Elevations in serum prolactin levels (hyperprolactinaemia) are a common side effect of conventional and some atypical antipsychotic treatments. In patients with schizophrenia, the adverse effects of antipsychotic-induced hyperprolactinaemia on physical health (e.g. fertility problems, sexual dysfunction and reduced bone mineral density) are gaining attention. Accumulating evidence shows consistent 'prolactin-raising' effects of conventional antipsychotics and risperidone compared with other current atypical antipsychotics, which are more likely to have 'prolactin-sparing' properties. Prolactin-sparing antipsychotics (for example, aripiprazole and quetiapine) tend to show lower frequencies of hyperprolactinaemia-associated side effects. In recent studies, aripiprazole-treated patients have demonstrated lower prolactin levels compared with patients receiving other prolactin-sparing antipsychotics. There is a lack of robust recommendations for monitoring prolactin elevation among patients receiving antipsychotics. Decreasing the antipsychotic dose or switching to a prolactin-sparing medication are possible management options for antipsychotic-induced hyperprolactinaemia. There is a need to increase awareness and understanding of the impact of antipsychotic-induced hyperprolactinaemia on physical health in schizophrenia.
Montejo
Angel L
AL
University Hospital of Salamanca, Av comuneros 27, Salamanca 37003, Spain. amontejo@usal.es
D014150:Antipsychotic Agents / Q000009:adverse effects; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced; D011388:Prolactin / Q000378:metabolism*; D012559:Schizophrenia / Q000188:drug therapy / Q000378:metabolism*; D012565:Schizophrenic Psychology; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced
D014150:Antipsychotic Agents; D011388:Prolactin