Prevalence of hyperprolactinemia in schizophrenic patients treated with conventional antipsychotic medications or risperidone11This work was sponsored by Eli Lilly and Company.

Kinon, Bruce J.; Gilmore, J.A.; Liu, Hong; Halbreich, Uriel

doi:10.1016/s0306-4530(02)00127-0

Cited by 220 publications

(179 citation statements)

References 26 publications

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“…Indeed, a strength of this paper is that the antipsychotic-free subjects were either antipsychotic-naïve (67%) or had received antipsychotics only for a short period of time. Moreover, those who had received antipsychotics had stopped for at least 3 weeks before the MRI scan, and this interval is sufficient for prolactin levels to decrease in patients switched from a prolactin-increasing to a prolactinspearing antipsychotic (Kinon et al, 2003). Therefore, we believe that there was no longer any effect of previous (typical) antipsychotics on pituitary volume in these antipsychotic-free subjects.…”

Section: Discussionmentioning

confidence: 99%

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

Pariante

Dazzan

Danese

et al. 2005

Neuropsychopharmacol

142

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Subjects at their first psychotic episode show an enlarged volume of the pituitary gland, but whether this is due to hypothalamicpituitary-adrenal (HPA) axis hyperactivity, or to stimulation of the prolactin-secreting cells by antipsychotic treatment, is unclear. We measured pituitary volume, using 1.5-mm, coronal, 1.5 T, high-resolution MRI images, in 78 patients at the first psychotic episode and 78 age-and gender-matched healthy controls. In all, 18 patients were antipsychotic-free (12 of these were antipsychotic-naïve), 26 were receiving atypical antipsychotics, and 33 were receiving typical antipsychotics. As hypothesized, patients had a larger pituitary volume than controls ( þ 22%, po0.001). When divided by antipsychotic treatment, and compared to controls, the pituitary volume was 15% larger in antipsychotic-free patients (p ¼ 0.028), 17% larger in patients receiving atypicals (p ¼ 0.01), and 30% larger in patients receiving typicals (po0.001). Patients receiving typicals not only had the largest pituitary volume compared to controls but also showed a trend for a larger pituitary volume compared to the other patients grouped together ( þ 11%, p ¼ 0.08). When divided by diagnosis, and compared to controls, the pituitary volume was 24% larger in patients with schizophrenia/schizophreniform disorder (n ¼ 40, po0.001), 19% larger in depressed patients (n ¼ 13, p ¼ 0.022), 16% larger in bipolar patients (n ¼ 16, p ¼ 0.037), and 12% larger in those with other psychoses (n ¼ 9, p ¼ 0.2). In conclusion, the first-episode of a psychotic disorder is associated with a larger pituitary independently of the presence of antipsychotic treatment, and this could be due to activation of the HPA axis. Typical antipsychotics exert an additional enlarging effect on pituitary volume, likely to be related to activation of prolactin-secreting cells. This activation of the hormonal stress response could participate to the important metabolic abnormalities observed in patients with psychosis.

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Section: Discussionmentioning

confidence: 99%

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

Pariante

Dazzan

Danese

et al. 2005

Neuropsychopharmacol

142

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“…1,3,4 Researches have shown an increase in prolactin in about 60% of patients taking 4 typical antipsychotics, 4,6 and there is evidence of the increase in mean prolactin levels of approximately three times above the normal limit in both genders. However, other studies suggest that atypical may be safer than typical neuroleptics in terms of BMD reduction 2 and seem to reduce the effect caused by the prolactin hormone.…”

Section: Discussionmentioning

confidence: 99%

“…However, other studies suggest that atypical may be safer than typical neuroleptics in terms of BMD reduction 2 and seem to reduce the effect caused by the prolactin hormone. 6 Antipsychotics are not recognized by the World Health Organization, neither by the Royal College of Physicians as risk factor for osteoporosis, and there are still no epidemiological studies to investigate the prevalence of BMD reduction in schizophrenic patients. Therefore, further studies are recommended.…”

Section: Discussionmentioning

confidence: 99%

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O impacto dos agentes antipsicóticos na densidade mineral óssea de pacientes esquizofrênicos

Guimarães

Leitão-Azevedo

Guerra

et al. 2006

Rev. psiquiatr. Rio Gd. Sul

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Estudos têm evidenciado o alto risco de osteoporose em pacientes esquizofrênicos. Alguns estudos têm demonstrado que os neurolépticos típicos e a risperidona podem induzir a osteoporose ou reduzir a densidade mineral óssea. Isso pode ser atribuído ao fato de estas drogas, em uso prolongado, induzirem a hiperprolactinemia a níveis acima do normal, em ambos os sexos, e a baixa dos níveis de estrogênio e de testosterona, aumentando o risco para osteopenia/osteoporose. Neste relato, será apresentado um caso de osteopenia em uma paciente mulher de 53 anos, em uso de antipsicóticos há 30 anos, sendo comentados os procedimentos recomendados para detecção dessa ocorrência e as diretrizes existentes para seu manejo.

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“…2,3 In fact, the prevalence of hyperprolactinaema among patients treated with antipsychotics was found to range from 56% to 67% for females and between 42% to 70% for males. 4,5 Rates were even higher among women of child bearing age and patients on risperidone monotherapy. 4,5 Persistent hyperprolactinaemia can have adverse effects including sexual dysfunction, menstrual disturbance, galactorrhoea and suppression of the hypothalamicpituitary-gonadal axis.…”

mentioning

confidence: 99%

QIP on baseline prolactin monitoring in psychiatric inpatients on antipsychotics

Ali¹,

Thomas²,

Looby³

et al. 2015

Prog. Neurol. Psychiatry

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Mental health patients suffer higher rates of mortality and morbidity due to physical health problems. A number of antipsychotics are associated with significant increases in plasma prolactin levels and the risk of hyperprolactinaemia. The importance of physical health monitoring is increasingly recognised and commissioned for in mental health services. In the context of greater focus on physical health monitoring in mental health settings, this project set out to assess and improve compliance with guidance on baseline prolactin level testing of inpatients on antipsychotics.

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Prevalence of hyperprolactinemia in schizophrenic patients treated with conventional antipsychotic medications or risperidone11This work was sponsored by Eli Lilly and Company.

Cited by 220 publications

References 26 publications

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

Increased Pituitary Volume in Antipsychotic-Free and Antipsychotic-Treated Patients of the Æsop First-Onset Psychosis Study

O impacto dos agentes antipsicóticos na densidade mineral óssea de pacientes esquizofrênicos

QIP on baseline prolactin monitoring in psychiatric inpatients on antipsychotics

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