Hyperprolactinemia associated with psychotropics--a review

Hum Psychopharmacol. Jun-Jul 2010;25(4):281-97. doi: 10.1002/hup.1116.

Abstract

Introduction: Different classes of psychotropics can cause hyperprolactinemia to varying degrees. Among antipsychotics, typical agents and risperidone are the most frequent and significant offenders. In this review we discuss the pathophysiology, offending medications, assessment and management of hyperprolactinemia.

Methods: We did a literature review between 1976 and 2008 using PubMed, MEDLINE, PsychINFO and Cochrane database. Search terms used were prolactin, hyperprolactinemia, psychotropics, antipsychotics, typical antipsychotics, atypical antipsychotics, antidepressants and SSRIs.

Results: Prolactin elevation is more common with antipsychotics than with other classes of drugs. Typical antipsychotics are more prone to cause hyperprolactinemia than atypical agents. Management options include discontinuation of offending medication, switching to another psychotropic, supplementing concurrent hormonal deficiencies and adding a dopamine agonist or aripiprazole.

Conclusion: Clinicians need to be alert about the potential for hyperprolactinemia and its manifestations with these medications. Prolactin levels need to be monitored and other causes of hyperprolactinemia ruled out in suspected cases.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Anxiety Agents / adverse effects
  • Anti-Anxiety Agents / therapeutic use
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use
  • Female
  • Humans
  • Hyperprolactinemia / chemically induced*
  • Hyperprolactinemia / drug therapy
  • Hyperprolactinemia / epidemiology
  • Hyperprolactinemia / metabolism
  • Male
  • Mental Disorders / drug therapy
  • Prolactin / blood
  • Prolactin / physiology
  • Psychotropic Drugs / adverse effects*
  • Psychotropic Drugs / therapeutic use

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents
  • Antipsychotic Agents
  • Psychotropic Drugs
  • Prolactin