title: Increased prolactin levels are associated with impaired processing speed in subjects with early psychosis.
abstract: Hyperprolactinaemia, a common side effect of some antipsychotic drugs, is also present in drug-naïve psychotic patients and subjects at risk for psychosis. Recent studies in non-psychiatric populations suggest that increased prolactin may have negative effects on cognition. The aim of our study was to explore whether high plasma prolactin levels are associated with poorer cognitive functioning in subjects with early psychoses. We studied 107 participants: 29 healthy subjects and 78 subjects with an early psychosis (55 psychotic disorders with <3 years of illness, 23 high-risk subjects). Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery, and prolactin levels were determined as well as total cortisol levels in plasma. Psychopathological status was assessed and the use of psychopharmacological treatments (antipsychotics, antidepressants, benzodiazepines) recorded. Prolactin levels were negatively associated with cognitive performance in processing speed, in patients with a psychotic disorder and high-risk subjects. In the latter group, increased prolactin levels were also associated with impaired reasoning and problem solving and poorer general cognition. In a multiple linear regression analysis conducted in both high-risk and psychotic patients, controlling for potential confounders, prolactin and benzodiazepines were independently related to poorer cognitive performance in the speed of processing domain. A mediation analysis showed that both prolactin and benzodiazepine treatment act as mediators of the relationship between risperidone/paliperidone treatment and speed of processing. These results suggest that increased prolactin levels are associated with impaired processing speed in early psychosis. If these results are confirmed in future studies, strategies targeting reduction of prolactin levels may improve cognition in this population.
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Itziar
authors.initials: I
authors.lastname: Montalvo
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Gutiérrez-Zotes
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Creus
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Monseny
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Ortega
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Franch
authors.affiliation: Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Lawrie
authors.affiliation: Endocrinology Unit, University/BHF Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Reynolds
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Vilella
authors.affiliation: Early Psychosis Program and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Labad
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects; D001569:Benzodiazepines / Q000009:adverse effects; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003072:Cognition Disorders / Q000097:blood* / Q000139:chemically induced / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000139:chemically induced / Q000503:physiopathology; D007555:Isoxazoles / Q000009:adverse effects; D008297:Male; D000068882:Paliperidone Palmitate; D011388:Prolactin / Q000097:blood*; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000097:blood* / Q000503:physiopathology*; D011743:Pyrimidines / Q000009:adverse effects; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D007555:Isoxazoles; D011743:Pyrimidines; D001569:Benzodiazepines; D011388:Prolactin; D000068882:Paliperidone Palmitate