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Management of psychotropic-induced hyperprolactinemia.
P A Marken1, R F Haykal, J N Fisher
1School of Pharmacy, University of Missouri-Kansas City 64108.
Clinical Pharmacy
|October 1, 1992
Summary
Psychotropic medications, particularly antipsychotics, can increase prolactin levels, causing adverse effects like infertility and sexual dysfunction. Managing these requires dosage adjustments or dopamine agonists for symptom relief.
Area of Science:
- Endocrinology
- Neuropharmacology
- Psychiatry
Background:
- Hyperprolactinemia, elevated serum prolactin, can cause significant adverse effects in both men and women.
- These effects include menstrual irregularities, anovulation, infertility, galactorrhea, impotence, and azoospermia.
Purpose of the Study:
- To describe the effects of psychotropic medications on serum prolactin concentrations.
- To provide recommendations for managing adverse effects associated with hyperprolactinemia.
Main Methods:
- Review of existing literature on psychotropic drug effects on prolactin.
- Analysis of mechanisms by which different drug classes influence prolactin secretion.
Main Results:
- Antipsychotic medications are most likely to cause symptomatic hyperprolactinemia by blocking dopamine receptors.
- The degree of prolactin elevation correlates with the antipsychotic dosage.
- Antidepressants can also elevate prolactin, but less frequently and with fewer severe clinical effects.
Conclusions:
- The primary management strategy for drug-induced hyperprolactinemia is antipsychotic dose reduction or discontinuation.
- Dopamine agonists like bromocriptine and amantadine can be effective for persistent symptoms.
- Other psychotropic agents like lithium, valproic acid, and benzodiazepines have a lower association with clinically significant hyperprolactinemia.