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Hyperprolactinemia is considered a troubling adverse effect of antipsychotics. Direct comparisons among second generation antipsychotics are scant in clinical practice. We hypothesize prolactin-sparing second-generation antipsychotics may have differential effects on prolactin levels and that they may be influenced by sex.
To explore the differential effect of three widely used prolactin-sparing antipsychotics, aripiprazole, quetiapine and ziprasidone, on prolactin plasma levels in first episode non-affective psychosis during a 1year of treatment.
From October 2005 to January 2011 a prospective, randomized, open-label study was undertaken. 141 patients who were randomly allocated to aripiprazole (N=56), quetiapine (N=36) or ziprasidone (N=49) were analyzed. The main outcome was differences in prolactin plasma levels over 1year follow-up among the three antipsychotics. Prolactin levels had a skewed distribution and therefore they were log-transformed before statistical analyses.
Male patients on aripiprazole had a lower risk of suffering an increase on prolactin plasma levels (N=71; F=12.645; p<0.001). There was a gender effect with smaller changes in mean prolactin values only in males. Aripiprazole had a reduced risk of hyperprolactinemia (aripiprazole 19.6%) compared to quetiapine (44.4%) and ziprasidone (32.7%) (p=0.038); and quite similar findings were found when investigating males (p=0.040). No significant differences were found in females. The percentages of mild prolactin excess were: 14.3% on aripiprazole, 36.1% on quetiapine and 18.4% on ziprasidone (?2=6.611 p=0.037).
Our findings provide additional evidence of differential effects of three sparing-prolactin antipsychotics on prolactin release and may help clinicians to decide among therapeutic options.
Fuente: Schizophr Res. 2017 Nov;189:134-141
Fecha de publicación: 01/11/2017
Nº de páginas: 8
Tipo de publicación: Artículo de Revista
Url de la publicación: https://dx.doi.org/10.1016/j.schres.2017.01.046
BENEDICTO CRESPO FACORRO
ORTIZ GARCIA DE LA FOZ, VICTOR
PAULA SUAREZ PINILLA
ELSA MARIA VALDIZAN RUIZ
PÉREZ IGLESIAS, ROCÍO
JOSE ANTONIO AMADO SEÑARIS
MARIA TERESA GARCIA UNZUETA
MARIA ROSA AYESA ARRIOLA