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KMID : 0361520090200040167
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Korean Journal of Psychopharmacology
2009 Volume.20 No. 4 p.167 ~ p.180
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Serious Short-Term and Long-Term Effects of Antipsychotic-Induced Hyperprolactinemia
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Park Young-Min
Lee Heon-Jeong
Choo Jung-Sook
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Abstract
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Many antipsychotics have the potential to increase plasma prolactin levels, leading to a range of short-term and long-term adverse effects. In addition to short-term adverse effects such as galactorrhea, gynecomastia, menstrual irregularities, and sexual dysfunction, a number of important and potentially serious long-term adverse effects have been reported, including loss of bone mineral density, weight gain, pituitary tumor, breast cancer, and prostate cancer. Short-term adverse effects may negatively impact medication compliance, and long-term effects have the potential for serious health consequences. However, to a large degree, hyperprolactinemia has been neglected in clinical practice and research, compared with other potential adverse effects. Balancing the benefits of treatment with antipsychotics against their potential adverse effects is clinically important. Effective management of hyperprolactinemia begins with taking a careful patient history to determine the presence of any relevant signs and symptoms. If a mild elevation of plasma prolactin levels is detected (<50 ng/mL), then it may be reasonable to continue to monitor the levels. If the elevation is persistent and >50 ng/mL, then the clinician should consider switching to a drug with a lower potential to elevate prolactin. In any patient with a prolactin elevation greater than 150 ng/mL, a prolactinoma should be considered.
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KEYWORD
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Antipsychotics, Adverse effect, Hyperprolactinemia, Prolactin
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