Antipsychotics and hyperprolactinaemia: mechanisms, consequences and management
Antipsychotics and hyperprolactinaemia: mechanisms, consequences and management
Hyperprolactinaemia is a common side effect in people receiving antipsychotics. The propensity to cause hyperprolactinaemia differs markedly between antipsychotics as a result of differential dopamine D2 receptor binding affinity and ability to cross the blood-brain barrier. Sexual dysfunction is common and under-recognised in people with severe mental illness and is in part caused by hyperprolactinaemia. There are a number of long term consequences of hyperprolactinaemia, including osteoporosis.
Regular monitoring before and during treatment will help identify those developing antipsychotic-induced hyperprolactinaemia. The treatment includes dose reduction and change in antipsychotic. Where this is not possible because of the risk of relapse of the mental illness, sex steroid replacement may be helpful in improving symptoms secondary to hypogonadism and reducing the risk of osteoporosis. Tertiary prevention of complications should also be considered.
severe mental illness, antipsychotic, hyperprolactinaemia, sexual dysfunction, osteoporosis, breast cancer, monitoring, management
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Peveler, Robet C.
12baa14b-34df-4e8d-b72e-cc7db086a776
23 April 2010
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Peveler, Robet C.
12baa14b-34df-4e8d-b72e-cc7db086a776
Holt, Richard I.G. and Peveler, Robet C.
(2010)
Antipsychotics and hyperprolactinaemia: mechanisms, consequences and management.
Clinical Endocrinology.
(doi:10.1111/j.1365-2265.2010.03814.x).
Abstract
Hyperprolactinaemia is a common side effect in people receiving antipsychotics. The propensity to cause hyperprolactinaemia differs markedly between antipsychotics as a result of differential dopamine D2 receptor binding affinity and ability to cross the blood-brain barrier. Sexual dysfunction is common and under-recognised in people with severe mental illness and is in part caused by hyperprolactinaemia. There are a number of long term consequences of hyperprolactinaemia, including osteoporosis.
Regular monitoring before and during treatment will help identify those developing antipsychotic-induced hyperprolactinaemia. The treatment includes dose reduction and change in antipsychotic. Where this is not possible because of the risk of relapse of the mental illness, sex steroid replacement may be helpful in improving symptoms secondary to hypogonadism and reducing the risk of osteoporosis. Tertiary prevention of complications should also be considered.
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e-pub ahead of print date: 23 April 2010
Published date: 23 April 2010
Keywords:
severe mental illness, antipsychotic, hyperprolactinaemia, sexual dysfunction, osteoporosis, breast cancer, monitoring, management
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Local EPrints ID: 157419
URI: http://eprints.soton.ac.uk/id/eprint/157419
PURE UUID: 08a498d4-a48e-4c87-a22f-0f1905283001
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Date deposited: 07 Jun 2010 10:40
Last modified: 14 Mar 2024 02:45
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Author:
Robet C. Peveler
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