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Management of Hyperprolactinemia in Patients Receiving Antipsychotics

Published online by Cambridge University Press:  07 November 2014

Abstract

Hyperprolactinemia is increasingly prevalent in patients with common psychiatric disorders due to increasing prescriptions of antipsychotics, particularly newer atypical neuroleptics, in these patients. However, measurement of prolactin levels is indicated only in symptomatic patients. When hyperprolactinemia is diagnosed, work-up should include exclusion of other causes of hyperprolactinemia, particularly those that might require treatment. Once such causes have been ruled out, a minority of patients with antipsychotic medication-induced hyperprolactinemia, including those with clinically significant signs and symptoms, will require treatment. When treatment is indicated, specifically when hyperprolactinemia results in amenorrhea in women or testosterone deficiency in men, dopamine agonist therapy is generally not advisable. Hormone-replacement therapy, which involves estrogen/progestogen in women and testosterone in men, can often prevent modification and interruption of successful psychiatric medication regimens.

Type
Academic Supplement
Copyright
Copyright © Cambridge University Press 2004

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References

REFERENCES

1. Kleinberg, DL, Davis, JM, De Coster, R, et al. Prolactin levels and adverse events in patients treated with risperidone. J Clin Psychopharmacol. 1999;19(1):5761.CrossRefGoogle ScholarPubMed
2. Kearns, AE, Goff, DC, Hayden, DL, et al. Risperidone-associated hyperprolactinemia. Endocr Proct. 2000;6:425429.CrossRefGoogle ScholarPubMed
3. Volavka, J, Czobor, P, Cooper, TB, et al. Prolactin levels in schizophrenia and schizoaffective disorder patients treated with clozapine, olanzapine, risperidone, or haloperidol. J Clin Psychiatry. 2004;65(1):5761.CrossRefGoogle ScholarPubMed
4. Klibanski, A, Biller, BM, Rosenthal, DI, et al. Effects of prolactin and estrogen deficiency in amenorrheic bone loss. J Clin Endocrinol Metab. 1988;67(1):124130.CrossRefGoogle ScholarPubMed
5. Becker, D, Liver, O, Mester, R, et al. Risperidone, butnotolanzapine, decreases bone mineral density in female premenopausal schizophrenia patients. J Clin Psychiatry. 2003;64(7):761766.CrossRefGoogle ScholarPubMed
6. Wang, PS, Walker, AM, Tsuang, MT, et al. Dopamine antagonists and the development of breast cancer. Arch Gen Psychiatry. 2002;59(12):11471154.CrossRefGoogle ScholarPubMed
7. Hankinson, SE, Willett, WC, Michaud, DS, et al. Plasma prolactin levels and subsequent risk of breast cancer in postmenopausal women. J Natl Cancer Inst. 1999;91:629634.CrossRefGoogle ScholarPubMed
8. Cohen, LG, Biederman, J, et al. Treatment of risperidone-induced hyperprolactinemia with a dopamine agonist in children. J Child Adolesc Psychopharmacol. 2001;11(4):435440.CrossRefGoogle ScholarPubMed
9. Cavallaro, R, Cocchi, F, Angelone, SM, et al. Cabergoline treatment of risperidone-induced hyperprolactinemia: a pilot study. J Clin Psychiatry. 2004;65(2):187190.CrossRefGoogle ScholarPubMed