International journal of psychiatry in clinical practice · 2025
Clinical outcomes and serum prolactin levels in patients with antipsychotic-induced hyperprolactinemia following different management strategies.
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Sangngarm Apiradee, Werawattanachai Chompoonuch, Somrak Kamonrat, Silaket Sipanut, Boonlue Tuanthon
Аннотация
OBJECTIVE: To evaluate the effects of different management strategies (watchful waiting, dose reduction, switching and adjunctive treatments) on prolactin levels and clinical outcomes in patients with antipsychotic-induced hyperprolactinaemia.
METHODS: A prospective cohort study was conducted with 135 adult patients diagnosed with hyperprolactinaemia due to antipsychotic use. Patients were assigned to four management groups: watchful waiting, dose reduction, switching and adjunctive treatment (with aripiprazole). Prolactin levels and clinical symptoms (e.g. galactorrhea, gynaecomastia, menstrual irregularities) were assessed before and after intervention.
RESULTS: Baseline prolactin levels were comparable across groups. Post-intervention, all groups exhibited significant reductions in prolactin levels, with the largest decrease observed in the switching and adjunctive treatment group (mean change: -68.3 and -67.1 ng/mL, respectively). Clinical outcomes also improved, with a notable reduction in galactorrhea (p = 0.04), gynaecomastia (p = 0.004) and menstrual irregularities across all groups (p = 0.02). No significant changes were observed in sexual dysfunction, hirsutism or acne.
CONCLUSION: Management strategies for antipsychotic-induced hyperprolactinaemia, particularly switching or adjunctive treatments, effectively reduce prolactin levels and improve related symptoms.
METHODS: A prospective cohort study was conducted with 135 adult patients diagnosed with hyperprolactinaemia due to antipsychotic use. Patients were assigned to four management groups: watchful waiting, dose reduction, switching and adjunctive treatment (with aripiprazole). Prolactin levels and clinical symptoms (e.g. galactorrhea, gynaecomastia, menstrual irregularities) were assessed before and after intervention.
RESULTS: Baseline prolactin levels were comparable across groups. Post-intervention, all groups exhibited significant reductions in prolactin levels, with the largest decrease observed in the switching and adjunctive treatment group (mean change: -68.3 and -67.1 ng/mL, respectively). Clinical outcomes also improved, with a notable reduction in galactorrhea (p = 0.04), gynaecomastia (p = 0.004) and menstrual irregularities across all groups (p = 0.02). No significant changes were observed in sexual dysfunction, hirsutism or acne.
CONCLUSION: Management strategies for antipsychotic-induced hyperprolactinaemia, particularly switching or adjunctive treatments, effectively reduce prolactin levels and improve related symptoms.