Prolactin related symptoms during risperidone maintenance treatment: results from a prospective, multicenter study of schizophrenia

Abstract

BackgroundThis study aimed to investigate prolactin related symptoms (PRS) in individuals with schizophrenia during risperidone maintenance treatment for one year, as well as to identify the risk factors for PRS.MethodsIn a multicenter, randomized, controlled, longitudinal study, clinically stabilized schizophrenia patients (N = 374) were randomized to a no-dose-reduction group (N = 129) and 4-week (N = 125) and 26-week (N = 120) reduction groups, in which the original dose was followed by a 50 % reduction over 8 weeks and subsequently maintained. PRS were assessed via a scale of prolactin related adverse events, which included 16 items: menstrual cycle, menstrual period, menstrual volume, menstrual irregularities, amenorrhea, dysmenorrhea, postpartum lactation, gynecomastia, breast tenderness, sexual dysfunction, decreased sexual desire, erectile dysfunction, ejaculatory dysfunction, impotence, increased body hair, and acne. The occurrence of PRS was assessed at baseline and monthly for six months, followed by every two months. A mixed model was used.ResultsPRS at baseline were reported in 18.4, 15.0, and 14.0 % of the 4-week, 26-week, and no-dose-reduction groups, respectively. Female gender, younger age at onset, and the Positive and Negative Syndrome Scale (PANSS) total scores at entry predicted the development of PRS. The mixed model indicated that PRS were more severe in females and at a high dose. In the 237 patients who remained in the study after one year, the incidence of PRS decreased to 9.6, 11.1, and 7.6 % in the 4-week, 26-week, and no-dose-reduction groups, respectively.ConclusionThese findings indicate that the PRS severity was alleviated during the one year treatment period because of the dose reduction. Attention should focus on the side effects of hyperprolactinemia during long-term treatment, especially with a high dose, females, younger age at onset, and more severe patients.Trial registrationClinicalTrials.gov identifier: NCT00848432. Registered February 19, 2009.

Adjunctive metformin for antipsychotic-related hyperprolactinemia: A meta-analysis of randomized controlled trials

“…AP-related hyperprolactinemia could accelerate bone degradation in male patients with schizophrenia (Bulut et al 2016). Furthermore, AP-related hyperprolactinemia is associated with increased body mass index (BMI) (Baptista et al, 2001) in male patients, while more severe prolactin related symptoms occur in female patients (Bo et al, 2016a). The association between prolactin and BMI could be explained by the fact that prolactin impairs the synthesis of the gonadal sex hormones leading to low serum estradiol levels and increased risk of obesity (Baptista et al, 2001).…”

Neuroendocrinology and neurobiology of sebaceous glands

“…Finally, anti‐psychotic medication is another key factor, well recognised for its ability to induce hyperprolactinaemia, which must be carefully monitored before and during treatment (Bo et al ., ; González‐Blanco et al ., ; Delgado‐Alvarado et al ., ). Clinically, the resultant hyperprolactinaemia is associated with gynaecomastia, galactorrhoea, menstrual dysfunction, and, in the context of skin, with the development of hirsutism and acne (Garnis‐Jones, ; Seeman, ; Bo et al ., ).…”

Sexual dysfunctions in schizophrenia: Beyond antipsychotics. A systematic review

“…SD have been associated with current psychotic symptomatology independently of the antipsychotic medication status, in both genders (Aizenberg et al, 1995;Bo et al, 2016;Bram et al, 2014;Fan et al, 2007;Fortier et al, 2003;Kelly and Conley, 2003;Kockott and Pfeiffer, 1996;Lee et al, 2015;Lyketsos et al, 1983;Macdonald et al, 2003;Malik et al, 2011;Millier et al, 2014;Olfson et al, 2005;Ong et al, 2014a;Simiyon et al, 2016;Ucok et al, 2007;Westheide et al, 2008).…”