Categorical prevalence and severity of hyperprolactinaemia in two UK cohorts of patients with severe mental illness during treatment with antipsychotics.
Hyperprolactinaemia may be associated with hidden longer-term consequences, such as osteoporosis, bone fractures, pituitary tumours and breast cancer. Prolactin data from clinical trials is not always reported in a categorical manner and does not always allow the risk of hyperprolactinaemia to be evaluated for specific patient cohorts. Patients participating in a physical health management programme in the UK for severe mental illness patients--the Well-being Support Programme--had prolactin measurements made regardless of symptoms. Prolactin data from the complete cohort of 178 patients receiving antipsychotics in Leeds and London are reported. Hyperprolactinaemia was measured in 33.1% but more commonly in females than males (47.3% and 17.6%) and was associated with all antipsychotics except clozapine. The highest prevalence rates were found in amisulpride (n=20) 89%, risperidone long-acting intramuscular injection (LAIM) 67% (n=6) and risperidone (n=30) 55% used as antipsychotic monotherapy. Clinically Significant hyperprolactinaemia (>1000 mIU/L approximately 47 ng/ml) was measured in 15.8% of patients, predominantly in females. Levels >2000 mIU/L approximately 95 ng/ml in 6.2% of the complete cohort. Clinicians may wish to add prolactin measurement to the routine laboratory parameters currently measured for some antipsychotics and should be advised of the potential longer-term consequences of hidden hyperprolactinaemia.
Bushe
Chris
C
Eli Lilly and Company Ltd., Basingstoke, UK. beesbeesbees@blueyonder.co.uk
Yeomans
David
D
Floyd
Tamsin
T
Smith
Shubulade M
SM
D014150:Antipsychotic Agents / Q000009:adverse effects*; D015331:Cohort Studies; D004739:England; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D015995:Prevalence; D011388:Prolactin / Q000097:blood*; D012042:Registries; D012720:Severity of Illness Index
D014150:Antipsychotic Agents; D011388:Prolactin