Hyperprolactinaemia during treatment with paliperidone.
OBJECTIVE
The aim of this paper is to highlight the association between antipsychotic medication, in this instance paliperidone, and hyperprolactinaemia, and discuss the impact of this adverse effect on patient management.


METHODS
Four patients with paliperidone-induced hyperprolactinaemia are described with a brief review of the literature.


RESULTS
Four female patients aged between 20 and 50 years developed hyperprolactinaemia 3 weeks to 4 months after commencement of treatment with paliperidone. The levels were significantly raised above the normal upper limit of 500 mIU/L, ranging between 1500 and 3996 mIU/L, and returned to within the normal range after cessation of the medication (82-381 mIU/L). Two of the patients were asymptomatic despite significant elevation of prolactin; two experienced galactorrhoea, a distressing adverse effect. Subsequent management was significantly affected.


CONCLUSIONS
Routine standardized monitoring of prolactin levels may guide treatment choice, avoiding potential disruption to the therapeutic relationship, enhancing compliance with future medication and preventing negative treatment outcomes. Detailed education should accompany the monitoring process and include discussion of the risks of associated adverse effects of antipsychotic medications versus the benefit of significant symptom relief.
Skopek
Michaela
M
Gosford Hospital, Northern Sydney Central Coast Area Health Service, NSW, Australia. michaelaskopek@gmail.com
Manoj
Puthenpurackal
P
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D005260:Female; D005687:Galactorrhea / Q000097:blood / Q000139:chemically induced; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000139:chemically induced*; D007555:Isoxazoles / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D000068882:Paliperidone Palmitate; D010349:Patient Compliance / Q000523:psychology; D010879:Piperazines / Q000627:therapeutic use; D011388:Prolactin / Q000097:blood; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D000069348:Quetiapine Fumarate; D015363:Quinolones / Q000627:therapeutic use; D012008:Recurrence; D012563:Schizophrenia, Paranoid / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D055815:Young Adult
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D007555:Isoxazoles; D010879:Piperazines; D011743:Pyrimidines; D015363:Quinolones; D000069348:Quetiapine Fumarate; D000068180:Aripiprazole; D011388:Prolactin; D000068882:Paliperidone Palmitate