title: Effects of aripiprazole, quetiapine and ziprasidone on plasma prolactin levels in individuals with first episode nonaffective psychosis: Analysis of a randomized open-label 1year study.
abstract: Hyperprolactinemia is considered a troubling adverse effect of antipsychotics. Direct comparisons among second generation antipsychotics are scant in clinical practice. We hypothesize prolactin-sparing second-generation antipsychotics may have differential effects on prolactin levels and that they may be influenced by sex.
  
  
  
  To explore the differential effect of three widely used prolactin-sparing antipsychotics, aripiprazole, quetiapine and ziprasidone, on prolactin plasma levels in first episode non-affective psychosis during a 1year of treatment.
  
  
  
  From October 2005 to January 2011 a prospective, randomized, open-label study was undertaken. 141 patients who were randomly allocated to aripiprazole (N=56), quetiapine (N=36) or ziprasidone (N=49) were analyzed. The main outcome was differences in prolactin plasma levels over 1year follow-up among the three antipsychotics. Prolactin levels had a skewed distribution and therefore they were log-transformed before statistical analyses.
  
  
  
  Male patients on aripiprazole had a lower risk of suffering an increase on prolactin plasma levels (N=71; F=12.645; p<0.001). There was a gender effect with smaller changes in mean prolactin values only in males. Aripiprazole had a reduced risk of hyperprolactinemia (aripiprazole 19.6%) compared to quetiapine (44.4%) and ziprasidone (32.7%) (p=0.038); and quite similar findings were found when investigating males (p=0.040). No significant differences were found in females. The percentages of mild prolactin excess were: 14.3% on aripiprazole, 36.1% on quetiapine and 18.4% on ziprasidone (χ2=6.611 p=0.037).
  
  
  
  Our findings provide additional evidence of differential effects of three sparing-prolactin antipsychotics on prolactin release and may help clinicians to decide among therapeutic options.
authors.affiliation: University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain. Electronic address: bcfacorro@humv.es.
authors.forename: Benedicto
authors.initials: B
authors.lastname: Crespo-Facorro
authors.affiliation: University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Ortiz-Garcia de la Foz
authors.affiliation: University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Suarez-Pinilla
authors.affiliation: CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Physiology and Pharmacology, and IBBTEC (UC-CSIC-SODERCAN), University of Cantabria, Spain.
authors.forename: Elsa M
authors.initials: EM
authors.lastname: Valdizan
authors.affiliation: CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Psychosis Studies Dep. PO63 5(th) floor. Main building, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London.
authors.forename: Rocío
authors.initials: R
authors.lastname: Pérez-Iglesias
authors.affiliation: Department of Endocrinology, Marqués de Valdecilla University Hospital, Avda. Valdecilla s/n, 39008, University of Cantabria, Spain.
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Amado-Señaris
authors.affiliation: Department of Biochemistry, Marques de Valdecilla University Hospital, Santander 39008, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Teresa Garcia-Unzueta
authors.affiliation: CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Salud Mental Parc Taulí, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Labad
authors.affiliation: The Zucker Hillside Hospital, Department of Psychiatry Research, 75-59 263rd Street, Glen Oaks, NY 11004, USA; Hofstra Northwell School of Medicine, Department of Psychiatry and Molecular Medicine, Hempstead, NY 11549, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Correll
authors.affiliation: University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ayesa-Arriola
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000627:therapeutic use; D010054:Brief Psychiatric Rating Scale; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010879:Piperazines / Q000627:therapeutic use; D011388:Prolactin / Q000097:blood* / Q000187:drug effects; D011618:Psychotic Disorders / Q000097:blood* / Q000188:drug therapy*; D000069348:Quetiapine Fumarate / Q000627:therapeutic use; D012727:Sex Characteristics; D013844:Thiazoles / Q000627:therapeutic use; D013997:Time Factors; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; D000069348:Quetiapine Fumarate; C092292:ziprasidone; D000068180:Aripiprazole; D011388:Prolactin
keywords: Adherence; Antipsychotics; NCT: 02305823; Schizophrenia; Treatment