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[Hyperprolactinemia in mentally ill patients]
Manuel Maria de Carvalho1, Carlos Góis
1Departamento de Psiquiatria e Saúde Mental, Hospital de Santa Maria, Lisbon, Portugal.
Acta Medica Portuguesa
|June 21, 2012
Summary
Hyperprolactinemia, a frequent side effect of antipsychotics, affects many patients but receives little attention. Management involves dose reduction, switching medications, or dopamine agonists, with potential long-term risks.
Area of Science:
- Psychiatry
- Endocrinology
- Pharmacology
Background:
- Hyperprolactinemia is a common adverse effect of antipsychotic medications, affecting a significant percentage of patients with schizophrenia.
- This condition is often overlooked compared to other antipsychotic side effects like extra-pyramidal symptoms.
- Both conventional and some atypical antipsychotics can cause elevated prolactin levels, termed prolactin-raising antipsychotics.
Purpose of the Study:
- To highlight the prevalence and clinical significance of hyperprolactinemia induced by antipsychotic treatment.
- To discuss the symptoms, potential long-term consequences, and differential diagnoses associated with hyperprolactinemia.
- To outline current management strategies for antipsychotic-induced hyperprolactinemia.
Main Methods:
- Review of existing literature on antipsychotic-induced hyperprolactinemia.
- Analysis of clinical symptoms and potential long-term health risks.
- Evaluation of management approaches including medication adjustments and pharmacological interventions.
Main Results:
- Hyperprolactinemia occurs in up to 75% of women and 42% of men treated with prolactin-raising antipsychotics.
- Symptoms include menstrual irregularities, infertility, sexual dysfunction, and potentially long-term effects like decreased bone density.
- Prolactin-sparing antipsychotics (e.g., clozapine, quetiapine) offer an alternative for managing this side effect.
Conclusions:
- Antipsychotic-induced hyperprolactinemia is a prevalent and significant clinical issue requiring greater attention.
- Effective management strategies exist, including switching to prolactin-sparing agents or using dopamine agonists.
- Current guidelines often lack recommendations for routine prolactin monitoring, necessitating a proactive clinical approach.
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