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Antipsychotics-induced hyperprolactinemia and screening for macroprolactin.

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Hyperprolactinemia (HPRL) is common in patients on antipsychotics. Macroprolactin presence did not significantly alter HPRL severity categorization in this study of female patients.

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Clinical Chemistry

Background:

  • Elevated prolactin (PRL) levels are a frequent side effect of antipsychotic medications.
  • Hyperprolactinemia (HPRL) severity may be influenced by macroprolactin in serum.
  • Understanding macroprolactin's impact is crucial for accurate HPRL assessment.

Purpose of the Study:

  • To compare total PRL concentrations with PRL levels after macroprolactin precipitation.
  • To evaluate changes in HPRL categorization based on PRL levels before and after macroprolactin removal.

Main Methods:

  • Assessed 98 female patients with psychotic disorders on antipsychotics and HPRL.
  • Measured total PRL and post-polyethylene glycol (PEG) precipitation PRL (postPEG-PRL) using chemiluminometric assays.
  • Analyzed data using intraclass correlation and kappa tests.

Main Results:

  • Total PRL and postPEG-PRL concentrations were highly correlated (mean estimation 0.96-0.98).
  • All patients exhibited HPRL regardless of macroprolactin precipitation.
  • HPRL severity categorization showed substantial agreement (kappa = 0.859) between total and postPEG-PRL levels.

Conclusions:

  • Macroprolactin presence does not significantly impact the categorization of HPRL severity in patients on antipsychotics.
  • Standard PRL measurements are reliable for assessing HPRL severity in this population.
  • The study confirms HPRL in all participants, irrespective of macroprolactin levels.