Dose requirement and prolactin elevation of antipsychotics in male and female patients with schizophrenia or related psychoses

Br J Clin Pharmacol. 2001 Apr;51(4):317-24. doi: 10.1046/j.1365-2125.2001.01352.x.

Abstract

Aims: The aim of this study was to investigate the prolactin (PRL) secretion and the growth hormone (GH)-insulin-like growth factor I (IGF-I) axis in relation to gender and side-effects and dose of antipsychotic drugs during long-term treatment.

Methods: Forty-seven patients (21 men and 26 women), diagnosed with schizophrenia or related psychoses according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria and treated with different classical antipsychotics, were studied. Prolactin, GH and IGF-I were measured, as well as the serum concentration of the antipsychotics. In addition, body mass index (BMI) was calculated.

Results: The median daily, as well as the median body weight, adjusted daily dose of antipsychotic drugs was twofold higher in male compared with female patients. Antipsychotic-induced hyperprolactinaemia was more frequent and occurred at a lower daily dose of antipsychotics in women. Irrespective of sex, more than half of the patients had elevated BMI. Two patients had a slight increment in IGF-I levels, whereas the GH concentration, as assessed on a single occasion, was normal in all patients.

Conclusions: Patients on long-term antipsychotic therapy, with doses adjusted according to therapeutic efficiency, exhibited hyperprolactinaemia and elevated BMI, but no obvious influence on the GH-IGF-I axis. Furthermore, it appeared that the males required twice the dose of antipsychotic compared with females.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / metabolism
  • Antipsychotic Agents / therapeutic use
  • Body Mass Index
  • Drug Interactions
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Human Growth Hormone / blood
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Luteinizing Hormone / blood
  • Male
  • Middle Aged
  • Prolactin / blood*
  • Schizophrenia / blood
  • Schizophrenia / drug therapy*
  • Schizophrenia / physiopathology
  • Sex Characteristics
  • Testosterone / blood

Substances

  • Antipsychotic Agents
  • Human Growth Hormone
  • Testosterone
  • Estradiol
  • Insulin-Like Growth Factor I
  • Prolactin
  • Luteinizing Hormone
  • Follicle Stimulating Hormone