Risk factors of hyperprolactinemia induced by risperidone and olanzapine and their correlations with plasma glucose and lipids

Abstract

<jats:sec><jats:title>Background</jats:title><jats:p>Hyperprolactinemia is a common adverse reaction in patients with schizophrenia who take antipsychotic drugs; it often leads to treatment non-compliance in patients and has an adverse effect on their prognosis.</jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p>This study aimed to explore the risk factors of elevated prolactin (PRL) caused by risperidone (RIS) and olanzapine (OLZ) and the relationship between PRL and fasting plasma glucose and lipids.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patients with schizophrenia were divided into two groups: 264 patients who were taking RIS and 175 patients who were taking OLZ. These two groups were further divided according to serum PRL levels: an elevated PRL group (&gt;30 ng/mL) and a normal PRL group (PRL ≤30 ng/mL). The demographics, medication dosage, fasting plasma glucose, total cholesterol and triglycerides were compared in the two groups. Logistic regression analysis was performed to explore the risk factors of elevated PRL levels.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Compared with the OLZ group, the RIS group had a greater number of patients with elevated PRL (155/264 vs 58/175). Either the RIS or the OLZ group, the proportion of elevated PRL was greater in female patients (RIS: χ<jats:sup>2</jats:sup>=6.76, p=0.009; OLZ: χ<jats:sup>2</jats:sup>=12.98, p&lt;0.001) and with higher doses of the related drugs (RIS: <jats:italic>U</jats:italic>=−3.73, p&lt;0.001; OLZ: <jats:italic>U</jats:italic>=−2.31, p=0.021). In patients taking RIS, the elevated PRL subgroup took the drug for a longer period (<jats:italic>U</jats:italic>=−2.76, p=0.006) and had lower triglyceride levels (<jats:italic>U</jats:italic>=2.76, p=0.006). In patients taking OLZ, the elevated PRL subgroup had lower fasting plasma glucose levels (<jats:italic>U</jats:italic>=2.29, p=0.022). Logistic regression analysis showed that gender, dose and fasting glucose levels were significantly associated with elevated PRL levels (RIS: p=0.001, OLZ: p&lt;0.001; RIS: p&lt;0.001; OLZ: p=0.003; RIS: p=0.020, OLZ: p=0.001, respectively).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Compared with OLZ, RIS had a greater effect on PRL in patients with schizophrenia, and in patients with schizophrenia taking RIS or OLZ, gender and dose were significantly correlated with the PRL value. Moreover, the plasma glucose level of the group with elevated PRL was lower than that of the group with normal PRL. The results also showed that high serum PRL may be associated with a favourable glucose metabolic profile in patients with schizophrenia taking RIS or OLZ. Further studies are warranted to confirm this association.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" specific-use="clinicaltrial results" xlink:href="NCT02640911">NCT02640911</jats:ext-link></jats:p></jats:sec>

Association of Serum Prolactin With Type 2 Diabetes Mellitus: A Comparative Cross-Sectional Study From South India

“…While these associations are only applicable to higher levels of PRL within the physiological range, high PRL levels in the non-physiological range due to prolactinoma or treatment with antipsychotic drugs have consistently been shown to unfavourably affect metabolic parameters [ 15 , 16 ]. A pathologically higher PRL level in patients with T2DM in a few studies has also been shown to be associated with increased diabetic complications, insulin resistance, and metabolic syndrome [ 17 ].…”

Challenges and opportunities in the diagnosis and treatment of early-onset psychosis: a case series from the youth affective disorders clinic in Stockholm, Sweden

“…For instance, antipsychotics are linked with increased neurological and metabolic adverse effects in young patients 26 , 27 , though strategies exist to lessen these effects 20 , 27 . Hyperprolactinemia is a clinically significant adverse effect of risperidone treatment in both adults 28 , 29 and, putatively, adolescents 30 . Clinical manifestations such as gynecomastia and galactorrhea represent potential concerns.…”

Safety and related factors of treatment with long-term atypical antipsychotic in Chinese patients with schizophrenia: observational study

“…At present, there are articles published on the analysis of the data in this study, and a pharmacodynamic model has been established to quantify the time-efficacy relationship of antipsychotic drugs. [31][32][33] Contributors WY and SH are responsible for the project implementation and the writing of the paper. JH is responsible for the project implementation and ethical review.…”