title: Risk of hyperprolactinemia and sexual side effects in males 10-20 years old diagnosed with autism spectrum disorders or disruptive behavior disorder and treated with risperidone.
abstract: OBJECTIVE
  The aim of this study was to investigate the long-term treatment effects of risperidone on prolactin levels and prolactin-related side effects in pubertal boys with autism spectrum disorders (ASD) and disruptive behavior disorders (DBD).
  
  
  METHODS
  Physical healthy 10-20-year-old males with ASD (n=89) and/ or DBD (n=9) chronically treated (mean 52 months, range 16-126 months) with risperidone (group 1, n=51) or not treated with any antipsychotic (group 2, n=47) were recruited to this observational study from the child psychiatry outpatient clinic. Morning non-fasting serum prolactin levels were measured and prolactin-related side effects were assessed by means of questionnaires and physical examination. Group differences were tested with Student's t, χ(2), Fisher exact, and Mann-Whitney tests, and logistic regression analysis, according to the type and distribution of data.
  
  
  RESULTS
  Hyperprolactinemia was present in 47% of subjects in group 1 but only in 2% of subjects in group 2 (odds ratio 71.9; 95% CI, 7.7; 676.3). Forty-six percent of subjects in group 1 had asymptomatic hyperprolactinemia. Current risperidone dose and 9-OH risperidone plasma level were significant predictors of hyperprolactinemia (p=0.035 and p=0.03, respectively). Gynecomastia and sexual dysfunction were present in 43% and 14% of the subjects in group 1, respectively, compared with 21% and 0% of subjects in group 2 (p=0.05 and p=0.01). Gynecomastia was not significantly associated with hyperprolactinemia.
  
  
  CONCLUSIONS
  Hyperprolactinemia is a common side effect in young males treated over the long term with risperidone. Young males treated with risperidone are more likely to report diminished sexual functioning than are those not treated with antipsychotics.
authors.affiliation: GGZ Centraal Psychiatric Centre, Amersfoort, The Netherlands. y.roke@ggzcentraal.nl
authors.forename: Yvette
authors.initials: Y
authors.lastname: Roke
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.forename: Annemieke M
authors.initials: AM
authors.lastname: Boot
authors.forename: Diederik
authors.initials: D
authors.lastname: Tenback
authors.forename: Peter N
authors.initials: PN
authors.lastname: van Harten
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000188:drug therapy*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D006177:Gynecomastia / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced* / Q000453:epidemiology; D007555:Isoxazoles / Q000097:blood; D016015:Logistic Models; D008297:Male; D000068882:Paliperidone Palmitate; D011388:Prolactin / Q000097:blood / Q000187:drug effects; D011743:Pyrimidines / Q000097:blood; D018967:Risperidone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000453:epidemiology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D007555:Isoxazoles; D011743:Pyrimidines; D011388:Prolactin; D018967:Risperidone; D000068882:Paliperidone Palmitate