[Antipsychotic-induced symptomatic hyperprolactinemia: clinical consequences and therapeutic strategies]

Hyperprolactinemia is a clinical condition characterized by a stable and persistent increase in the ematic prolactin levels. That condition presents some serious health consequences for the affected subjects determining both sexual and endocrine not sexual dysfunctions. Drugs which act on the dopaminergic system and/or on the dopamine hypophysis receptors, could increase the prolactin levels. Traditional antipsychotics used in the treatment of the schizophrenia, are one of the pharmachological classes more involved in this condition and a wide data from international literature describes its clinical and phisiopathologic characteristics. Generally, the atypical antipsychotic induce a significant lower increase of prolactin levels as regards the traditional ones However, above all in young psychotic patients treated with these new drugs, it has been shown an increase of prolactin levels over the superior limit of the normal range, in 70% of them. One of the reasons which more frequently induce a psychotic patient to interrupt an antipsychotic treatment, is represented by the presence of side effects expecially in the sexual sphere. These consequences are greater and more significant in young patients. For such reasons, the therapeutic alternatives to be consider in symptomatic hyperprolactinemia depend on a complete evaluation of the risk/benefit relationship considering the possibility of shifting to another antipsychotic drug, or using drugs with dopaminergic activity which, however, could be associate to some side effects and could determine a worsening of psychotic symptoms.