Hyperprolactinaemia with amisulpride

Raj, Rajnish; Sidhu, Balwant Singh

doi:10.4103/0019-5545.39761

Cited by 11 publications

(10 citation statements)

References 16 publications

(16 reference statements)

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“…This study shows that even low‐dosage amisulpride below 300 mg/day can increase serum prolactin level. This finding is consistent with the previous reports indicating that low‐dosage amisulpride elevates serum prolactin levels 9–13 . Some studies reported elevated prolactin levels by even 50 mg/day of amisulpride 10,12,13 .…”

Section: Discussionsupporting

confidence: 93%

“…This finding is consistent with the previous reports indicating that low-dosage amisulpride elevates serum prolactin levels. [9][10][11][12][13] Some studies reported elevated prolactin levels by even 50 mg/day of amisulpride. 10,12,13 Our data found a significant correlation between the prolactin level and the dosage of amisulpride (P = 0.049).…”

Section: Discussionmentioning

confidence: 99%

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Hyperprolactinemia induced by low‐dosage amisulpride in Korean psychiatric patients

Lee¹,

Kim³

et al. 2012

Psychiatry Clin Neurosci

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Aim: Amisulpride at low dosages enhances dopaminergic neurotransmission by preferentially blocking presynaptic D2/D3 receptors. Thus, low dosages of amisulpride are expected not to increase prolactin levels. The aim of this study was to examine whether low dosages of amisulpride can increase serum levels of prolactin or not clinically in Korean patients. Method: Serum prolactin levels were measured in 20Korean patients (12 men and eight women) with various diagnoses who were treated with less than 300 mg of amisulpride per day.Results: The mean dosage of amisulpride was 195.0 Ϯ 51.0 mg/day, and serum level of prolactin was 76.1 Ϯ 43.4 ng/mL. The prolactin level was significantly higher in women (110.7 Ϯ 49.3 ng/mL) than in men (53.1 Ϯ 15.9 ng/mL) after administering amisulpride (P = 0.021), while the dosage of amisulpride did not differ significantly between men (200.0 Ϯ 42.6 mg/day) and women (187.5 Ϯ 64.1 mg/day) (P = 0.576). Conclusions:The low dosages of amisulpride elevate serum prolactin level in the majority of patients. This finding indicates that the dose-reduction of amisulpride has little effect to relieve amisulpride-induced hyperprolactinemia at therapeutic dosages. Clinicians should monitor serum prolactin level even when low dosages of amisulpride are administered.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Hyperprolactinemia induced by low‐dosage amisulpride in Korean psychiatric patients

Lee¹,

Kim³

et al. 2012

Psychiatry Clin Neurosci

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“…Amisulpride, a substituted benzamide derivative, is a second-generation antipsychotic that preferentially binds to D2/D3 receptors in limbic rather than striatal structures. 4 The effect on prolactin secretion is due to a blockade of pituitary action of the tuberoinfundibular dopaminergic system. Amisulpride has a potent prolactin-elevating effect, similar to conventional antipsychotic drugs.…”

Section: Case Discussionmentioning

confidence: 99%

“…Amisulpride has a potent prolactin-elevating effect, similar to conventional antipsychotic drugs. 4 Aripiprazole is a potent partial agonist of the D2 receptors.It exhibits functional agonist properties under hypodopaminergic conditions but acts as functional antagonist at D2 receptors under hyperdopaminergic conditions. 5 Aripiprazole may therefore inhibit prolactin secretion by blocking D2 receptors in the pituitary gland (where the dopamine neuronal activity is tonically controlled) and function as a dopaminergic agonist at low levels of dopaminergic neuronal activity.…”

Section: Case Discussionmentioning

confidence: 99%

Galactorrhea Distressing Side Effects of Amisulpride

2019

ARC Journal of Pharmaceutical Sciences

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“…4 It is proposed as an augmenting agent to clozapine and possibly deals with clozapine-induced hypersalivation, too. 7 Aripiprazole, a D2 partial agonist, D3 antagonist, 5HT-1A partial agonist, and 5HT-2A antagonist, is proposed as another add-on medication to clozapine, but its benefit seems limited primarily on improving the metabolic parameters altered by the latter. 7 Aripiprazole, a D2 partial agonist, D3 antagonist, 5HT-1A partial agonist, and 5HT-2A antagonist, is proposed as another add-on medication to clozapine, but its benefit seems limited primarily on improving the metabolic parameters altered by the latter.…”

Section: Case Reportmentioning

confidence: 99%

Pipamperone Augmentation of Clozapine and Sodium Valproate in Refractory Schizophrenia

Paraschakis

2014

Clinical Neuropharmacology

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Refractory schizophrenia poses many therapeutic dilemmas. Clozapine is currently considered as the most effective medication for the treatment of refractory schizophrenia. Unfortunately, it carries serious and often life-threatening adverse effects such as agranulocitosis, hypersalivation, somnolence, weight gain, diabetes, and epileptic seizures. Various combinations of clozapine with typical and other atypical antipsychotics have been suggested to improve its efficacy and reduce its often dose-related adverse effects. We present a case of a 37-year-old patient with refractory schizophrenia who has responded well to the combination of clozapine, sodium valproate, and pipamperone. The improvement was more evident in the following symptoms: auditory hallucinations, delusions, formal thought disorder, anhedonia, and social withdrawal. The combination was well tolerated: No extrapyramidal adverse effects were noted and the patient's full blood count was within normal limits. Pipamperone, a butyrophenone derivative, is a more selective antagonist of dopaminergic D4 receptors compared with D2 receptors and a serotoninergic 5HT-2A receptors antagonist. Thus, it shows "atypicality" and shares common characteristics with clozapine: 5HT-2A antagonism and D4 > D2 blockade selectivity. Therefore, augmentation of clozapine with pipamperone theoretically should have a synergistic effect that may provide several benefits to the patient: better antipsychotic efficacy with low risk for extrapyramidal adverse effects. This combination may also allow a decrease in clozapine dose, limiting its challenging adverse effects. To the author's knowledge, successful treatment of refractory schizophrenia with this drug combination is reported for the first time in the literature and probably merits further research.

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Hyperprolactinaemia with amisulpride

Cited by 11 publications

References 16 publications

Hyperprolactinemia induced by low‐dosage amisulpride in Korean psychiatric patients

Hyperprolactinemia induced by low‐dosage amisulpride in Korean psychiatric patients

Galactorrhea Distressing Side Effects of Amisulpride

Pipamperone Augmentation of Clozapine and Sodium Valproate in Refractory Schizophrenia

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