Prolactin Responses to Neuroleptics in Normal and Schizophrenic Subjects

Gruen, Peter; Sachar, Edward J.; Langer, Gerhard; Altman, Norman H.; M, Leifer; Frantz, Andrew G.; Halpern, Frieda S.

doi:10.1001/archpsyc.1978.01770250110011

Cited by 199 publications

(59 citation statements)

References 58 publications

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“…Gonadal dysfunctions such as amenorrhea and galactorrhea can be found in these patients as well, and the estimated prevalence of amenorrhea in patients who use fi rst-generation antipsychotics is from 15% to 50%, 49 and 19% for galactorrhea. 50 First-generation antipsychotics seem to create an increase in dose-dependent prolactin secretion 51,52 and this effect suggests that is derived primarily from the pituitary. 53 According to evidence relating to the use of serotonergic antidepressants, their infl uence on sexual function appear to be associated with decreased libido, erectile dysfunction and orgasmic dysfunction.…”

Section: Resultsmentioning

confidence: 99%

A systematic review on clinical management of antipsychotic-induced sexual dysfunction in schizophrenia

2006

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INTRODUCTION: Sexual dysfunction frequently occurs in patients with schizophrenia under antipsychotic therapy, and the presence of sexual side effects may affect compliance. The aim of this study was to review and describe clinical findings relating to the appropriate management of such dysfunctions. MATERIAL AND METHODS: The research was carried out through Medline (from 1966 to March 2005), PsycInfo (from 1974 to March 2005), and Cochrane Library (from 1965 to March 2005) and included any kind of study, from case reports to randomized trials. RESULTS: The most common sexual dysfunctions found in the literature were libido decrease, difficulties in achieving and maintaining erection, ejaculatory dysfunction, orgasmic dysfunction, and menstrual irregularities. Thirteen papers were found: eight of them were open-label studies, four were descriptions of cases, and only one was a randomized clinical trial. All of them were short-term and had small sample sizes. The agents used were: bromocriptine, cabergoline, cyproheptadine, amantadine, shakuyaku-kanzo-to, sildenafil and selegiline. DISCUSSION: There was no evidence that those agents had proper efficacy in treating the antipsychotic-induced sexual dysfunction. An algorithm for managing sexual dysfunction induced by antipsychotics is suggested as a support for clinical decisions. Since the outcome from schizophrenia treatment is strongly related to compliance with the antipsychotics, prevention of sexual dysfunction is better than its treatment, since there is a scarcity of data available regarding the efficacy of intervention to deal with these problems.

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Section: Resultsmentioning

confidence: 99%

A systematic review on clinical management of antipsychotic-induced sexual dysfunction in schizophrenia

2006

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“…Variations in PRL levels by age and sex PRL serum levels in unmedicated male adults average 7 ng/mL (Friesen and Hwang 1973;Meltzer et al 1974;Gruen et al 1978;Siemens 2012). PRL serum levels are similar between male and female children, mildly higher in adolescents than in children, similar in adolescents as in adults, and generally higher in women of menstrual age (averaging 10-12 ng/mL) than in adult men (Friesen and Hwang 1973;Cook et al 1992;Siemens 2012).…”

Section: Discussionmentioning

confidence: 99%

“…However, it should be noted that for children, the medians and means have similar distributions. It is possible that differences in PRL levels could be influenced by the underlying psychiatric condition, although no evidence of this was found in two studies (Friesen and Hwang 1973;Gruen et al 1978).…”

Section: Limitationsmentioning

confidence: 95%

Prolactin Serum Concentrations During Aripiprazole Treatment in Youth

Safer

Calarge

Safer

2013

Journal of Child and Adolescent Psychopharmacology

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Objective: This study aimed to: document the extent of the reduction of serum prolactin (PRL) levels induced by aripiprazole (ARI) treatment in children and adolescents, compare this effect by age group, and shed light on this phenomenon. Methods: PRL serum levels in unmedicated subjects were compared to those in subjects treated with aripiprazole to calculate the rate of subnormal PRL levels during aripiprazole treatment. Next, a literature search was performed to better understand the effects of dopaminergic drugs on PRL levels by age group. Results: Sixty percent of those treated with aripiprazole exhibited subnormal PRL serum levels versus 8% of unmedicated subjects. The rate of PRL subnormality in response to aripiprazole was half as frequent in adolescents and was minimal in adults. The drug-induced reduction of PRL serum levels became more prominent with increasing doses of aripiprazole and with an increased treatment duration. Conclusions: With the increasing use of aripiprazole in the United States population, it is important that future research be conducted to explore the potential sequelae of subnormal PRL serum levels in children and adolescents.

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“…Hypothalamic releasing hormone elevates prolactin to only a slight extent (Gruen, Sachar, Altman, Leifer, Frantz & Halpern, 1978a;Gruen, Sachar, Altman, Langer, Tabrizi & Halpern, 1978b;Meltzer, Goode, Schyre, Young & Fang, 1979). This drug does appear to have anti-psychotic activity (Meltzer et al, 1979) but clinical studies have been limited by the fact that its administration is associated with the development of agranulocytosis (Idanpaan-Hakkila, Alhava & Olkinvora, 1977) and it has therefore been withdrawn from some European countries.…”

Section: Pituitary Hormonementioning

confidence: 99%

“…It has been shown that the administration of neuroleptics leads to a reproducible and dosedependent elevation of PRL secretion in the individual subject (Langer, Sachar, Gruen & Halpern, 1977) but these relationships are much weaker if groups of patients are studied. A positive relationship between the antipsychotic effect of neuroleptics and the associated elevation of PRL secretion has been demostrated (Meltzer & Fang, 1976;Cotes, Crow, Johnstone, Bartlett & Bourne, 1978;Siris, van Kamman & de Fraites, 1978) but the relationship is not strong and the effect is only obvious at low doses of neuroleptics as a ceiling effect develops (Gruen et al, 1978a). There is a time lag (Cotes et al, 1978) (Kolakowska, Wiles, McNeilly & Gelder, 1975) and (b) the rate of fall in PRL after cessation of neuroleptic therapy and extrapyramidal symptoms (Brown, Laughren & Robzyk, 1979) but these studies require confirmation.…”

Section: Pituitary Hormonementioning

confidence: 99%