リスペリドンおよびパリペリドン誘発性高プロラクチン血症の日常臨床における検討：UAEからの人口統計学的および薬理学的決定因子

Antipsychotic-induced hyperprolactinemia is a common and clinically relevant adverse effect of dopamine D2-blocking agents such as risperidone and paliperidone, yet evidence from Arab populations is scarce. This study explored demographic and pharmacological predictors of hyperprolactinemia in a large UAE cohort. A retrospective cross-sectional study was conducted at the Behavioral Science Institute, Al Ain Hospital, using electronic medical records from 2017 to 2023. Adults (≥18 years) with schizophrenia (Diagnostic and Statistical Manual, fifth edition) treated with risperidone or paliperidone (oral or long-acting injectable) for greater than or equal to 6 weeks before serum prolactin assessment were included. Among 835 patients, the mean age was 40.2 ± 14.0 years; 53.8% were male and 58.4% Emirati. The mean prolactin level was 1126 ± 1334 mIU/l; 61.9% had hyperprolactinemia. The paliperidone-oral group showed the highest mean prolactin (1369 mIU/l; P = 0.003). Sexual side effects occurred in 9.2%. Predictors included younger age, female gender, non-Emirati nationality, paliperidone use, and aripiprazole cotreatment. Hyperprolactinemia was common, particularly among younger females and patients receiving oral paliperidone, and was accompanied by marked under-recognition of sexual side effects. Our study underscores the need for routine endocrine monitoring, rational prescribing to minimize polypharmacy, and region-specific clinical guidelines in the UAE and Gulf region.