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Management of antipsychotic-induced hyperprolactinaemia

  • Sumeet Gupta, Dev A. M. Lakshmanan, Udayan Khastgir and Rajesh Nair

Hyperprolactinaemia is a common endocrine disorder that can be associated with significant morbidity. Antipsychotic medications are frequently linked to hyperprolactinaemia. This disorder usually presents as menstrual problems in women and sexual problems in men, which affect the patients' quality of life and adherence to antipsychotic treatment. In the past, treatment for hyperprolactinaemia was recommended only for symptomatic patients. However, it has become clear that persistent asymptomatic hyperprolactinaemia can be associated with long-term physical morbidities such as osteoporosis and possibly breast cancer. Hence, it is imperative that hyperprolactinaemia is managed even if asymptomatic when initially detected. This article discusses the various management options, such as reducing the dose of antipsychotic medication, switching to a prolactin-sparing antipsychotic and adding aripiprazole to the treatment regimen.

Learning Objectives

• Understand the physiology of the prolactin hormone

• Be able to judge when to intervene if a patient on an antipsychotic medication presents with hyperprolactinaemia

• Learn about the different treatment options

Corresponding author
Correspondence Dr Sumeet Gupta, West Park Hospital, Edward Pease Way, Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington DL2 2TS, UK. Email:
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For another view on this important topic, see Wadoo et al (2017) Hyperprolactinaemia: a guide for psychiatrists. BJPsych Advances, 23: 158–166.

Declaration of Interest

S.G. has received speaker fees from Lundbeck. U.K. has received an honorarium for chairing a meeting from Lundbeck. R.N. has received speaker fees from Lundbeck and Sunovion, and sponsorship for educational meetings from Lundbeck and Jansenn.

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Management of antipsychotic-induced hyperprolactinaemia

  • Sumeet Gupta, Dev A. M. Lakshmanan, Udayan Khastgir and Rajesh Nair
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