Antidepressant use and circulating prolactin levels

Reeves, Katherine W.; Okereke, Olivia I.; Qian, Jing; Tworoger, Shelley S.; Rice, Megan S.; Hankinson, Susan E.

doi:10.1007/s10552-016-0758-x

Cited by 10 publications

(5 citation statements)

References 36 publications

(56 reference statements)

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“…Prior reports of SSRI-related prolactin increases were based primarily on small, highly selected clinical populations. Our recent analysis within the NHS and NHSII cohorts did not observe increased prolactin levels among women using ADs or SSRIs, specifically (38), which is consistent with our present report of no relationship between AD use and breast cancer risk. The increased risk of in situ disease we observed is intriguing, yet requires confirmation in other prospective cohorts.…”

Section: Discussionsupporting

confidence: 92%

Depression, Antidepressant Use, and Breast Cancer Risk in Pre- and Postmenopausal Women: A Prospective Cohort Study

Reeves

Okereke

Qian

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Depression and antidepressant use is highly prevalent among U.S. women and may be related to increased breast cancer risk. However, prior studies are not in agreement regarding an increase in risk. We conducted a prospective cohort study within the Nurses' Health Study (NHS) and NHSII among females age 25 and older. Over more than 10 years of follow-up in each cohort, 4,014 incident invasive breast cancers were diagnosed. We used Cox proportional hazards regressions with updating of exposures and covariates throughout follow-up to estimate HRs and 95% confidence intervals (CIs) for associations between clinical depression and antidepressant use with invasive breast cancer risk. Analyses were repeated separately for disease, as well as stratified by estrogen receptor (ER) subtype and menopausal status at diagnosis. No statistically significant associations were observed between clinical depression (HR for reporting ≥3 times vs. 0, 1.13; 95% CI, 0.85-1.49) or antidepressant use (HR for reporting ≥3 times vs. 0, 0.92; 95% CI, 0.80-1.05) and invasive breast cancer risk in multivariable analyses. Likewise, we observed no significant associations between clinical depression or antidepressant use and risk of , ER, ER, premenopausal, or postmenopausal breast cancer. In the largest prospective study to date, we find no evidence that either depression or antidepressant use increase risk of breast cancer. The results of this study are reassuring in that neither depression nor antidepressant use appear to be related to subsequent breast cancer risk. .

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Section: Discussionsupporting

confidence: 92%

Depression, Antidepressant Use, and Breast Cancer Risk in Pre- and Postmenopausal Women: A Prospective Cohort Study

Reeves

Okereke

Qian

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…On the contrary, an analysis of 610 patients from the Nurses’ Health Study published in 2016 showed that the prolactin level was not different between antidepressant users, nonusers and SSRI users. Moreover, the longitudinal analysis among SSRI users showed no significant change over time (Reeves et al ., 2016). This study focused on the long-term effect of SSRIs as the second measurement of prolactin occurred 11 years after the baseline evaluation.…”

Section: Discussionmentioning

confidence: 99%

Effect of sertraline on depression severity and prolactin levels in women with polycystic ovary syndrome: a placebo-controlled randomized trial

Masoudi

Ansari²,

Kashani

et al. 2021

International Clinical Psychopharmacology

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There is a paucity of data regarding the safety and efficacy of antidepressant therapy in women with polycystic ovary syndrome and depression. The effect of antidepressant medications on circulating prolactin levels is of concern in this patient population. We aimed to evaluate the effect of sertraline on depression severity and serum prolactin levels in women with polycystic ovary syndrome and mildto-moderate depression. In a parallel-design, two-center, randomized controlled trial, we stratified participants according to their baseline prolactin level into normal (<25 ng/mL) and high (≥25 ng/mL) prolactin groups. Each group was randomized to receive 50 mg daily sertraline (up-titrated after 25 mg daily for 1 week) or placebo. The enrolling physicians, outcome assessors, and study subjects were all blind to the treatment. Depression severity was assessed by the Hamilton depression rating scale at baseline, the third, and the sixth weeks. The primary efficacy outcome was a change in depression severity. Prolactin levels were checked at baseline and after 6 weeks, and the safety outcome was the alteration in prolactin levels. Overall, 513 women were screened for eligibility in two outpatient clinics. Ultimately, 74 (38 normal prolactin and 36 high prolactin level) individuals were randomized. After 6 weeks of follow-up, depression severity was significantly reduced among patients who received sertraline regardless of the baseline prolactin levels (all between subjects P < 0.001). Furthermore, there was no difference in prolactin levels between the sertraline and placebo arms in normal (P = 0.80) or high prolactin (P = 0.21) groups. Sertraline is a well-tolerated and effective choice for treating depression in women with polycystic ovary syndrome. Future studies with longer follow-up periods are required to draw more robust conclusions.

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“…The influence of antidepressant treatment on PRL levels is less known [ 38 , 39 ]. A study by Reeves et al in 2016 did not show a relationship between the use of antidepressants and increased PRL concentrations; however, they reported increases in PRL concentrations after antidepressant treatment in obese women [ 40 ]. This supports the equally important aspect that depression can be treated not only as a primary phenomenon, but also as a secondary phenomenon resulting from other disorders.…”

Section: Prl and Neuropsychiatric Disordersmentioning

confidence: 99%

The Involvement of Prolactin in Stress-Related Disorders

Faron-Górecka

Latocha

Pabian

et al. 2023

IJERPH

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The most important and widely studied role of prolactin (PRL) is its modulation of stress responses during pregnancy and lactation. PRL acts as a neuropeptide to support physiological reproductive responses. The effects of PRL on the nervous system contribute to a wide range of changes in the female brain during pregnancy and the inhibition of the hypothalamic–pituitary axis. All these changes contribute to the behavioral and physiological adaptations of a young mother to enable reproductive success. PRL-driven brain adaptations are also crucial for regulating maternal emotionality and well-being. Hyperprolactinemia (elevated PRL levels) is a natural and beneficial phenomenon during pregnancy and lactation. However, in other situations, it is often associated with serious endocrine disorders, such as ovulation suppression, which results in a lack of offspring. This introductory example shows how complex this hormone is. In this review, we focus on the different roles of PRL in the body and emphasize the results obtained from animal models of neuropsychiatric disorders.

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Antidepressant use and circulating prolactin levels

Cited by 10 publications

References 36 publications

Depression, Antidepressant Use, and Breast Cancer Risk in Pre- and Postmenopausal Women: A Prospective Cohort Study

Depression, Antidepressant Use, and Breast Cancer Risk in Pre- and Postmenopausal Women: A Prospective Cohort Study

Effect of sertraline on depression severity and prolactin levels in women with polycystic ovary syndrome: a placebo-controlled randomized trial

The Involvement of Prolactin in Stress-Related Disorders

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