Antipsychotics and hyperprolactinaemia: mechanisms, consequences and management.
Hyperprolactinaemia is a common side effect in people receiving antipsychotics. The propensity to cause hyperprolactinaemia differs markedly between antipsychotics as a result of differential dopamine D(2) receptor-binding affinity and ability to cross the blood-brain barrier. Sexual dysfunction is common and under-recognized in people with severe mental illness and is in part caused by hyperprolactinaemia. There are a number of long-term consequences of hyperprolactinaemia, including osteoporosis. Regular monitoring before and during treatment will help identify those developing antipsychotic-induced hyperprolactinaemia. The treatment includes dose reduction and change in antipsychotic. Where this is not possible because of the risk of relapse of the mental illness, sex steroid replacement may be helpful in improving symptoms secondary to hypogonadism and reducing the risk of osteoporosis. Tertiary prevention of complications should also be considered.
Holt
Richard I G
RI
Endocrinology and Metabolism Sub-Division, Developmental Origins of Adult Health and Disease Division, University of Southampton School of Medicine, Southampton, UK. righ@soton.ac.uk
Peveler
Robert C
RC
D014150:Antipsychotic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced* / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced
D014150:Antipsychotic Agents