Impact of antipsychotics on prolactin levels in youth with psychiatric disorders: A cross-sectional study.

OBJECTIVE

The increasing prescription of antipsychotics for children and adolescents raises concerns regarding abnormal prolactin levels. However, prolactin monitoring is rarely conducted (0.1-10 %), and the prevalence and characteristics of abnormal prolactin levels remain unclear. This study aimed to investigate the prevalence of abnormal prolactin levels and identify the factors influencing serum prolactin levels in pediatric and adolescent patients treated with antipsychotics in a real-world clinical setting.

METHOD: This retrospective cross-sectional study was conducted at Nagoya University Hospital and included consecutive 489 patients with psychiatric disorders aged <18 years who underwent serum prolactin monitoring. Because all hospitalized patients were included, sampling bias was minimized. Data on patient demographics, psychiatric diagnoses, medications, and prolactin levels were extracted and analyzed. Multiple regression analysis was performed to identify the factors influencing serum prolactin levels. Analysis of covariance was used to assess the effects of different antipsychotics on prolactin levels.

RESULTS

Hyperprolactinemia was observed in 23.0 % of patients treated with antipsychotics, whereas hypoprolactinemia was observed in 13.7 % of patients. Domperidone, sulpiride, and antipsychotics significantly increased prolactin levels. Risperidone, olanzapine, and blonanserin were associated with significantly increased serum prolactin levels, whereas aripiprazole was associated with hypoprolactinemia.

CONCLUSION

Approximately 40 % of pediatric patients treated with antipsychotics exhibited abnormal prolactin levels. Clinicians should routinely monitor prolactin levels and consider prolactin-related side effects when prescribing antipsychotics to children and adolescents. These findings emphasize the importance of tailored antipsychotic therapy to minimize the adverse effects in this vulnerable population.