title: Effects of cabergoline on hyperprolactinemia, psychopathology, and sexual functioning in schizophrenic patients.
abstract: Antipsychotic medications are associated to different degrees with sexual dysfunction mainly through their potential to induce hyperprolactinemia. Prolactin (PRL) secretion is mainly regulated by the hypothalamic dopaminergic systems. We conducted this 6-month, parallel-group study to prospectively investigate the effects of the dopamine agonist cabergoline on sexual dysfunction in clinically stable patients with schizophrenia (DSM-IV, AP 194) and hyperprolactinemia (PRL > 20 ng/ml for men and PRL > 25 ng/ml for women). In total 80 patients were enrolled; 33 were receiving risperidone, 17 haloperidol, 11 amisulpride, and 8 risperidone microspheres long acting. Based on PRL levels (< 50, 50-99, or > 100 ng/ml), patients were assigned in 3 cabergoline doses (0.25, 0.5, and 1 mg/day in 38, 23, and 19 patients, respectively). The psychopathology was evaluated using the Positive and Negative Syndrom Scale (PANSS), and sexual dysfunction was evaluated using the Arizona Sexual Experiences Scale (ASEX). PRL levels were reduced in all patients, from 73.3 (± 46.8) to 42.0 (± 27.8) at Month 3 and 27.1 (± 20.4) at Month 6 (p < .001). ASEX scores declined from 19.1 (± 5.1) to 17.6 (± 5.5) at Month 3 and 15.0 (± 6.5) at Month 6 (p < .001). PANSS scores were reduced in the third and in the sixth month (p = .001 at 6 month vs. baseline). The decrease in PRL was not statistically different between groups. Our data suggest that cabergoline administration to clinically stable patients with schizophrenia may improve sexual functioning without adversely affecting their psychopathologic status, provided that the dose has been suited to the severity of the hyperprolactinemia.
authors.affiliation: Psychiatric Department, Sismanoglio General Hospital, Athens, Greece. ckalkavoura@yahoo.gr
authors.forename: Christina S
authors.initials: CS
authors.lastname: Kalkavoura
authors.forename: Ioannis
authors.initials: I
authors.lastname: Michopoulos
authors.forename: Periklis
authors.initials: P
authors.lastname: Arvanitakis
authors.forename: Pitsa
authors.initials: P
authors.lastname: Theodoropoulou
authors.forename: Konstantina
authors.initials: K
authors.lastname: Dimopoulou
authors.forename: Errikos
authors.initials: E
authors.lastname: Tzebelikos
authors.forename: Lefteris
authors.initials: L
authors.lastname: Lykouras
mesh_terms: D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000077465:Cabergoline; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004873:Ergolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008137:Longitudinal Studies; D060046:Maintenance Chemotherapy; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000037:antagonists & inhibitors* / Q000097:blood; D011446:Prospective Studies; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000517:prevention & control*; D013469:Sulpiride / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D018491:Dopamine Agonists; D004873:Ergolines; D013469:Sulpiride; D000077582:Amisulpride; D011388:Prolactin; D006220:Haloperidol; D018967:Risperidone; D000077465:Cabergoline