Problems in long-term treatment with atypical antipsychotics: hyperprolactinemia

Abstract

Introduction

Schizophrenia and other psychotic disorders are associated with high rates of morbidity and mortality, caused by the use of specific treatments as well as health factors directly related to those processes. One of the high-frequency side effects in patients treated with classic and atypical antipsychotics is hyperprolactinemia. It causes alterations in neuroendocrine sphere (amenorrhea, galactorrhea, gynecomastia…), and other mid- and long-term effects (osteoporosis, cardiovascular risk increase and increased risk of developing cancers - specifically in breasts and endometrium).

Objectives

Check hyperprolactinemia induction by maintained treatment with atypical antipsychotics.

Methodology

A naturalistic prospective study was conducted following 75 patients on maintenance treatment with a single atypical antipsychotic during 24 months. Anthropometric and laboratory data were collected, along with the presence of different endocrine-metabolic during the 2-year study alterations.

Results

Changes in prolactin levels were found in a large number of patients, with statistically significant differences between 0 (basal) and 24 months (Basal [M = 26.27; SD = 21], 2 years [M = 38.08, SD = 34.65]; t = −2.758; P = 0.013], with hyperprolactinemia increasing from 46.6% of patients at baseline to 65.5% at 2 years, mainly with paliperidone and risperidone long acting injection (statistically significant increase in both cases) (Fig. 1).

Conclusions

Paliperidone and risperidone long acting injectable induce increased prolactin levels in patients in long-term antipsychotic treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Fig. 1 Prolactine variation at 24 months.