The Relationships Between Hyperprolactinemia, Metabolic Disturbance, and Sexual Dysfunction in Patients With Schizophrenia Under Olanzapine Treatment

Abstract

The aim of the study was to assess the relationship between prolactin levels and sexual dysfunction in patients with schizophrenia who use olanzapine medication. The potential risk factors of hyperprolactinemia and sexual dysfunction were also investigated. Patients with schizophrenia undergoing olanzapine monotherapy were invited to participate in this cross-sectional study. The Arizona Sexual Experiences Scale (ASEX) and the Positive and Negative Syndrome Scale were used to evaluate subjective sexual dysfunction and psychopathology, respectively. Levels of prolactin and metabolic parameters were also measured. In total, 279 participants with schizophrenia were recruited. The overall incidences of hyperprolactinemia, sexual dysfunction, and metabolic syndrome were 51.6, 53.8, and 43.7%, respectively. Higher ASEX scores, higher insulin levels, female sex, and younger age were associated with hyperprolactinemia. Prolactin level was significantly correlated with ASEX score. Elevated prolactin levels, concomitant antidepressant, increased insulin resistance, longer illness duration, and female sex were associated with sexual dysfunction. Female participants recorded higher levels of sexual dysfunction than their male counterparts did, whereas male participants had comparatively lower prolactin levels and lower rates of spousal partnership. Hyperprolactinemia, metabolic syndrome, and sexual dysfunction are prevalent in patients with schizophrenia treated with olanzapine. Clinicians should maintain awareness of these problems and monitor them regularly with their patients.

Sexual Dysfunction in Schizophrenia

“…Seventy-two studies published between 1979 and 2021 were included in the random-effects model . The flow diagram is presented in Figure 1.…”

Towards better care for women with schizophrenia-spectrum disorders

“…64 Hyperprolactinaemia and secondary hypogonadism cause side-effects such as hirsutism, painful breast tension, sexual dysfunction, polycystic ovary syndrome, and osteoporosis, and increase the risk of breast cancer. [72][73][74] This increased risk is especially worrisome because genetic similarities have been shown between breast cancer and schizo phrenia phenotypes, 75 and women with SSD are less inclined to visit breast cancer screening facilities and less often follow treatment guidelines, which results in increased mortality (odds ratio 1•55; 95% CI 1•32-1•82). 76 Taken together, the mental and somatic health of women with SSD can be improved substantially when hormonal dysregulation can be prevented.…”

Co-prescription of aripiprazole on prolactin levels in long-term hospitalized chronic schizophrenic patients with co-morbid type 2 diabetes: A retrospective clinical study

“…Among the many atypical antipsychotics, risperidone is considered to have one of the most significant effects on elevating prolactin (PRL) levels in psychiatric patients, and the PRL- increasing pharmacological effects of olanzapine should not be underestimated ( 1 ). A study from the Chinese province of Taiwan found that olanzapine can cause high levels of PRL (up to 51.6%) ( 4 ). What’s more, risperidone and olanzapine are two of the top-ranked antipsychotic drugs in terms of prescription rates, according to reports of prescribing patterns for psychiatric patients from around the world, including China ( 5 – 8 ).…”