A randomized, crossover comparison of herbal medicine and bromocriptine against risperidone-induced hyperprolactinemia in patients with schizophrenia.
Hyperprolactinemia is a common adverse effect that occurs as a result of antipsychotic therapies, which often results in discontinuation. Empirical evidence has shown that some herbal medicines have suppressive effects on prolactin (PRL) hyperactivities. This study was designed to compare the herbal preparation called Peony-Glycyrrhiza Decoction (PGD) with bromocriptine (BMT), a dopamine agonist widely used for PRL-secreting disorders, in the treatment of risperidone-induced hyperprolactinemia. Twenty schizophrenic women who were under risperidone maintenance treatment, diagnosed with hyperprolactinemia (serum PRL levels >50 mug/L), and currently experiencing oligomenorrhea or amenorrhea were selected for the study. Subjects were randomized to additional treatment with PGD (45 g/d) followed by BMT (5 mg/d) or BMT followed by PGD at the same doses for 4 weeks each, with an interval of 4-week washout period between 2 treatment sessions. The severity of psychotic symptoms, adverse events, serum PRL, estradiol, testosterone, and progesterone levels were examined at baseline and end point. Peony-Glycyrrhiza Decoction treatment produced a significant baseline-end point decrease in serum PRL levels, without exacerbating psychosis and changing other hormones, and the decreased amplitudes were similar to those of BMT (24% vs 21%-38%). Moreover, there was a significantly greater proportion of patients during PGD treatment than BMT treatment showing improvements on adverse effects associated with hyperprolactinemia (56% vs 17%, P = 0.037). These results suggest that the herbal therapy can yield additional benefits while having comparable efficacy in treating antipsychotic-induced hyperprolactinemia in individuals with schizophrenia.
Yuan
Hai-Ning
HN
Laboratory of Clinical Psychopharmacology, Beijing Anding Hospital, Capital Medical University, Beijing, China.
Wang
Chuan-Yue
CY
Sze
Cho Wing
CW
Tong
Yao
Y
Tan
Qing-Rong
QR
Feng
Xiu-Jie
XJ
Liu
Rui-Mei
RM
Zhang
Ji-Zhi
JZ
Zhang
Yan-Bo
YB
Zhang
Zhang-Jin
ZJ
D000328:Adult; D000568:Amenorrhea / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy; D014150:Antipsychotic Agents / Q000627:therapeutic use / Q000633:toxicity*; D001971:Bromocriptine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D006035:Glycyrrhiza; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy*; D009839:Oligomenorrhea / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy; D029596:Paeonia; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D018967:Risperidone / Q000627:therapeutic use / Q000633:toxicity*; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*; D013739:Testosterone / Q000097:blood
D014150:Antipsychotic Agents; D004365:Drugs, Chinese Herbal; D010936:Plant Extracts; D001971:Bromocriptine; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D018967:Risperidone