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Elevation of prolactin levels by atypical antipsychotics
Peter Turrone1, Shitij Kapur, Mary V Seeman
1Department of Psychiatry, University of Toronto, Ont. , Canada. peter_turrone@camh.net
The American Journal of Psychiatry
|January 5, 2002
Summary
Atypical antipsychotics, like risperidone, olanzapine, and clozapine, can temporarily increase prolactin levels in men with schizophrenia. The duration and degree of this elevation differ from typical antipsychotics.
Area of Science:
- Neuropharmacology
- Endocrinology
- Psychiatry
Background:
- Atypical antipsychotics are commonly prescribed for schizophrenia.
- Elevated prolactin levels (hyperprolactinemia) are a known side effect of typical antipsychotics.
- The effect of atypical antipsychotics on prolactin levels is less understood, with some evidence suggesting minimal impact.
Purpose of the Study:
- To investigate the prolactin-elevating effects of commonly used atypical antipsychotics (risperidone, olanzapine, clozapine).
- To compare the transient prolactin response to atypical antipsychotics with that of typical antipsychotics.
Main Methods:
- 18 male patients with schizophrenia were enrolled.
- Prolactin levels were monitored over 24 hours post-dose.
- Patients received daily oral doses of risperidone, olanzapine, or clozapine.
Main Results:
- Baseline prolactin levels were high in the risperidone group but normal in olanzapine and clozapine groups.
- All three atypical antipsychotics doubled prolactin levels at 6 hours post-administration.
- Olanzapine's prolactin increase did not reach statistical significance.
Conclusions:
- Atypical antipsychotics can transiently increase prolactin levels in male schizophrenia patients.
- Differences between atypical and typical antipsychotics lie in the degree and duration of prolactin elevation.
- Differential binding to pituitary dopamine D(2) receptors likely explains these effects.