October - December 2018, Volume 14, Issue 4

Matei VP, Purnichi T, Mihailescu A, Grigoras R

Prolactin Level in Patients with First Episode Schizophrenia Treated for One Year with Atypical Antipsychotics

Acta Endo (Buc) 2018, 14 (4): 483-490
doi: 10.4183/aeb.2018.483

Context. Atypical antipsychotics (AAs) are the first-line treatments for schizophrenia, schizoaffective disorder and bipolar disorder. However, they are now extensively utilized as off label in a myriad of diseases despite their frequently serious metabolic side-effects and hyperprolactinemia. Objective. The purpose of our study was to observe long-term (one year) prolactin level change in first episode schizophrenia patients treated with one of the four AAs: olanzapine, quetiapine, amisulpride, ziprasidone. Design. This study is an analysis of the prolactin level associated with the atypical antipsychotics used in European First Episode Schizophrenia Trial (EUFEST) study. Subjects and Methods. Seventy-three first episode schizophrenia patients from the 113 patients, randomized to one of the four AAs treatment arms. Prolactin level was obtained at baseline, 6 and 12 months for all the four AAs. Analyses have been done for each antipsychotic separately for each sex. Results. For the male patients neither of the four antipsychotics have been associated with a statistically significant increase of prolactin level in the entire study (p>0.05). In case of the female patients, treatment with olanzapine (p=.021) and ziprasidone (p=.005) has been associated with a decrease of prolactin level in one year compared with baseline. Conclusions. In both men and women, the administration of these four AAs is not associated with the increase of prolactin levels, moreover, in women’s case, there is a reduction of prolactin values at administration of Olanzapine and Ziprasidone. These results are optimistic, suggesting that long term administration of these antipsychotics is safe regarding prolactin level.

Keywords: antipsychotics, hyperprolactinemia, psychosis.

Correspondence: Valentin Petre Matei MD, “Prof. Dr. Alexandru Obregia” Clinical Psychiatric Hospital, Psychiatry, 2nd Department, Berceni Street, no.10, District 4, Bucharest, 041914, Romania, E-mail: valipmatei@yahoo.com