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Hyperprolactinaemia during treatment with paliperidone.
Michaela Skopek1, Puthenpurackal Manoj
1Gosford Hospital, Northern Sydney Central Coast Area Health Service, NSW, Australia. michaelaskopek@gmail.com
Summary
Paliperidone, an antipsychotic, can cause hyperprolactinaemia (elevated prolactin levels). Monitoring prolactin is crucial for managing this side effect and ensuring effective patient treatment.
Area of Science:
- Endocrinology
- Psychopharmacology
- Clinical Medicine
Background:
- Antipsychotic medications are essential for managing various psychiatric conditions.
- Hyperprolactinaemia, a condition of elevated prolactin, is a known potential side effect of certain antipsychotics.
- Paliperidone is a second-generation antipsychotic used in treating schizophrenia and schizoaffective disorder.
Observation:
- This study details four female patients (aged 20-50) who developed hyperprolactinaemia after starting paliperidone.
- Prolactin levels ranged from 1500 to 3996 mIU/L, significantly exceeding the normal upper limit of 500 mIU/L.
- Symptoms included galactorrhoea in two patients, while two remained asymptomatic despite high prolactin levels.
Findings:
- Hyperprolactinaemia resolved upon discontinuation of paliperidone, with prolactin levels returning to normal (82-381 mIU/L).
- The adverse effect of hyperprolactinaemia impacted the subsequent management of these patients.
- The onset of elevated prolactin levels occurred between 3 weeks and 4 months after initiating paliperidone treatment.
Implications:
- Routine monitoring of prolactin levels in patients on paliperidone is recommended.
- Monitoring can help guide treatment decisions, prevent therapeutic disruption, and improve medication adherence.
- Patient education on the risks and benefits of antipsychotic medications, including potential side effects like hyperprolactinaemia, is vital for optimal outcomes.
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