Pharmacopsychiatry 2012; 45(02): 57-63
DOI: 10.1055/s-0031-1291175
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Relationship between Prolactin Levels and Subjective Endocrine-Related Adverse Effects in Patients with Schizophrenia Receiving Long-Term Treatment with Amisulpride

E. Y. Kim
1   Department of Neuropsychiatry, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea
,
S. H. Kim
1   Department of Neuropsychiatry, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea
,
N. Y. Lee
1   Department of Neuropsychiatry, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea
,
D. C. Jung
1   Department of Neuropsychiatry, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea
,
Y. S. Kim
1   Department of Neuropsychiatry, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea
2   Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Jongno-Gum, Seoul, Republic of Korea
3   Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Jongno-Gu, Seoul, Republic of Korea
,
Y. M. Ahn
1   Department of Neuropsychiatry, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea
2   Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Jongno-Gum, Seoul, Republic of Korea
3   Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Jongno-Gu, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

received 23 February 2011
revised 06 July 2011

accepted 05 September 2011

Publication Date:
12 March 2012 (online)

Abstract

Introduction:

We have investigated the categorical prevalence of hyperprolactinemia and examined the relationship between prolactin levels and subjective endocrine-related adverse effects in schizophrenia patients treated with amisulpride during a 1-year period.

Methods:

A total of 111 patients with schizophrenia who were either started on or switched to amisulpride were assessed for prolactin levels and endocrine-related adverse effects using 6 items derived from the Liverpool University neuroleptic side-effect rating scale (LUNSERS) at baseline, 8 weeks, and 1 year.

Results:

10 were antipsychotic-naïve, 23 were antipsychotic free for 1 month, 54 discontinued their medication during 1 month prior to study, and 24 maintained their antipsychotics at baseline. At 1 year, hyperprolactinemia was found in 75.9% of men and 85.7% of women. Significant increases in mean prolactin levels at week 8 in both sexes were found; this was followed by a significant decrease over 1 year only in women. The proportions of both sexes with hyperprolactinemia increased from baseline to week 8 but remained unchanged at 1 year. Scores on the endocrine-related items of the LUNSERS improved significantly from baseline to week 8 in both sexes and then remained consistent during maintenance treatment. Prolactin levels were significantly higher in the group with baseline hyperprolactinemia than in the group without baseline hyperprolactinemia at all assessment points.

Conclusions:

Amisulpride commonly induces hyperprolactinemia. Although the percentage of patients with hyperprolactinemia remained unchanged during maintenance treatment, serum prolactin levels significantly decreased among women. Self-reported endocrine-related side effects were not associated with prolactin elevation during amisulpride treatment.

 
  • References

  • 1 Wieck A, Haddad PM. Antipsychotic-induced hyperprolactinemia in women: pathophysiology, severity and consequences. Selective literature review. Br J Psychiatry 2003; 182: 199-204
  • 2 Haddad PM, Wieck A. Antipsychotic-induced hyperprolactinemia: mechanisms, clinical features and management. Drugs 2004; 64: 2291-2314
  • 3 Hummer M, Huber J. Hyperprolactinemia and antipsychotic therapy in schizophrenia. Curr Med Res Opin 2004; 20: 189-197
  • 4 Meaney AM, O’Keane V. Prolactin and schizophrenia: clinical consequences of hyperprolactinemia. Life Sci 2002; 71: 979-992
  • 5 Baggaley M. Sexual dysfunction in schizophrenia: focus on recent evidence. Hum Psychopharmacol 2008; 23: 201-209
  • 6 Meltzer HY, Goode DJ, Schyve PM et al. Effect of clozapine on human serum prolactin levels. Am J Psychiatry 1979; 136: 1550-1555
  • 7 Small JG, Hirsch SR, Arvanitis LA et al. Quetiapine in patients with schizophrenia. A high- and low-dose double-blind comparison with placebo. Seroquel Study Group. Arch Gen Psychiatry 1997; 54: 549-557
  • 8 Tollefson GD, Kuntz AJ. Review of recent clinical studies with olanzapine. Br J Psychiatry Suppl 1999; 30-35
  • 9 Reavley A, Fisher AD, Owen D et al. Psychological distress in patients with hyperprolactinemia. Clin Endocrinol (Oxf) 1997; 47: 343-348
  • 10 Sobrinho LG. The psychogenic effects of prolactin. Acta Endocrinol (Copenh) 1993; 129 Suppl 1 38-40
  • 11 Finn SE, Bailey JM, Schultz RT et al. Subjective utility ratings of neuroleptics in treating schizophrenia. Psychol Med 1990; 20: 843-848
  • 12 Lambert M, Conus P, Eide P et al. Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence. Eur Psychiatry 2004; 19: 415-422
  • 13 Olfson M, Uttaro T, Carson WH et al. Male sexual dysfunction and quality of life in schizophrenia. J Clin Psychiatry 2005; 66: 331-338
  • 14 Byerly MJ, Nakonezny PA, Bettcher BM et al. Sexual dysfunction associated with second-generation antipsychotics in outpatients with schizophrenia or schizoaffective disorder: an empirical evaluation of olanzapine, risperidone, and quetiapine. Schizophr Res 2006; 86: 244-250
  • 15 Eberhard J, Lindstrom E, Holstad M et al. Prolactin level during 5 years of risperidone treatment in patients with psychotic disorders. Acta Psychiatr Scand 2007; 115: 268-276
  • 16 Howes OD, Wheeler MJ, Pilowsky LS et al. Sexual function and gonadal hormones in patients taking antipsychotic treatment for schizophrenia or schizoaffective disorder. J Clin Psychiatry 2007; 68: 361-367
  • 17 Johnsen E, Kroken RA, Abaza M et al. Antipsychotic-induced hyperprolactinemia: a cross-sectional survey. J Clin Psychopharmacol 2008; 28: 686-690
  • 18 Cutler AJ. Sexual dysfunction and antipsychotic treatment. Psychoneuroendocrinology 2003; 28 Suppl 1 69-82
  • 19 Dossenbach M, Dyachkova Y, Pirildar S et al. Effects of atypical and typical antipsychotic treatments on sexual function in patients with schizophrenia: 12-month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study. Eur Psychiatry 2006; 21: 251-258
  • 20 Kinon BJ, Ahl J, Liu-Seifert H et al. Improvement in hyperprolactinemia and reproductive comorbidities in patients with schizophrenia switched from conventional antipsychotics or risperidone to olanzapine. Psychoneuroendocrinology 2006; 31: 577-588
  • 21 Knegtering H, Boks M, Blijd C et al. A randomized open-label comparison of the impact of olanzapine versus risperidone on sexual functioning. J Sex Marital Ther 2006; 32: 315-326
  • 22 Liu-Seifert H, Kinon BJ, Tennant CJ et al. Sexual dysfunction in patients with schizophrenia treated with conventional antipsychotics or risperidone. Neuropsychiatr Dis Treat 2009; 5: 47-54
  • 23 Schlosser R, Grunder G, Anghelescu I et al. Long-term effects of the substituted benzamide derivative amisulpride on baseline and stimulated prolactin levels. Neuropsychobiology 2002; 46: 33-40
  • 24 Bushe C, Yeomans D, Floyd T et al. Categorical prevalence and severity of hyperprolactinemia in two UK cohorts of patients with severe mental illness during treatment with antipsychotics. J Psychopharmacol 2008; 22: 56-62
  • 25 Bushe C, Shaw M. Prevalence of hyperprolactinemia in a naturalistic cohort of schizophrenia and bipolar outpatients during treatment with typical and atypical antipsychotics. J Psychopharmacol 2007; 21: 768-773
  • 26 Kopecek M, Bares M, Svarc J et al. Hyperprolactinemia after low dose of amisulpride. Neuro Endocrinol Lett 2004; 25: 419-422
  • 27 Paparrigopoulos T, Liappas J, Tzavellas E et al. Amisulpride-induced hyperprolactinemia is reversible following discontinuation. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31: 92-96
  • 28 Ahn YM, Lee KY, Kim CE et al. Changes in neurocognitive function in patients with schizophrenia after starting or switching to amisulpride in comparison with the normal controls. J Clin Psychopharmacol 2009; 29: 117-123
  • 29 Jung HY, Joo YH, Shin HK et al. A validation study of Korea-version of Liverpool University neuroleptic side effect rating scale (LUNSERS). J Korean Neuropsychiatr Assoc 2002; 41: 138-145
  • 30 Kinon BJ, Gilmore JA, Liu H et al. Prevalence of hyperprolactinemia in schizophrenic patients treated with conventional antipsychotic medications or risperidone. Psychoneuroendocrinology 2003; 28 Suppl 2 55-68
  • 31 Brown WA, Laughren TP. Tolerance to the prolactin-elevating effect of neuroleptics. Psychiatry Res 1981; 5: 317-322
  • 32 Crawford AM, Beasley Jr CM, Tollefson GD. The acute and long-term effect of olanzapine compared with placebo and haloperidol on serum prolactin concentrations. Schizophr Res 1997; 26: 41-54
  • 33 Faraone SV, Brown WA, Laughren TP. Serum neuroleptic levels, prolactin levels, and relapse: a two-year study of schizophrenic outpatients. J Clin Psychiatry 1987; 48: 151-154
  • 34 Rao ML, Brown WA. Stability of serum neuroleptic and prolactin concentrations during short- and long-term treatment of schizophrenic patients. Psychopharmacology (Berl) 1987; 93: 237-242
  • 35 Compton MT, Miller AH. Antipsychotic-induced hyperprolactinemia and sexual dysfunction. Psychopharmacol Bull 2002; 36: 143-164
  • 36 Turrone P, Kapur S, Seeman MV et al. Elevation of prolactin levels by atypical antipsychotics. Am J Psychiatry 2002; 159: 133-135
  • 37 Kuruvilla A, Peedicayil J, Srikrishna G et al. A study of serum prolactin levels in schizophrenia: comparison of males and females. Clin Exp Pharmacol Physiol 1992; 19: 603-606
  • 38 Smith SM, O’Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry 2002; 181: 49-55
  • 39 Wode-Helgodt B, Eneroth P, Fyro B et al. Effect of chlorpromazine treatment on prolactin levels in cerebrospinal fluid and plasma of psychotic patients. Acta Psychiatr Scand 1977; 56: 280-293
  • 40 Aizenberg D, Zemishlany Z, Dorfman-Etrog P et al. Sexual dysfunction in male schizophrenic patients. J Clin Psychiatry 1995; 56: 137-141
  • 41 Knegtering H, van der Moolen AE, Castelein S et al. What are the effects of antipsychotics on sexual dysfunctions and endocrine functioning?. Psychoneuroendocrinology 2003; 28 Suppl 2 109-123
  • 42 Macdonald S, Halliday J, Mac ET et al. Nithsdale Schizophrenia Surveys 24: sexual dysfunction. Case-control study. Br J Psychiatry 2003; 182: 50-56
  • 43 Grunder G, Wetzel H, Schlosser R et al. Neuroendocrine response to antipsychotics: effects of drug type and gender. Biol Psychiatry 1999; 45: 89-97