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Treatment of hyperprolactinemia

Tao Luo, Qiao-Sheng Liu, Yuan-Jian Yang, Bo Wei
BACKGROUND: It is well known that aripiprazole co-treatment effectively reduces antipsychotic-induced hyperprolactinemia. However, the effectiveness of aripiprazole to treat high prolactin levels induced by antidepressant drugs with serotoninergic activity, such as duloxetine, remains unknown. CASE PRESENTATION: An 18-year-old female diagnosed with major depressive disorder (MDD) was treated with 100 mg sertraline once daily. After two weeks, galactorrhoea was observed...
March 5, 2019: Journal of Affective Disorders
Nuran Ekinci, Serkan Güneş, Merve Kalinli, Özalp Ekinci
Amenorrhea is one of the clinical consequences of hyperprolactinemia. Although symptomatic hyperprolactinemia is among the well-described adverse reactions of antipsychotic agents, it may also be reported with the use of selective serotonin reuptake inhibitors. Hereby, we present a case of sertraline-related hyperprolactinemic amenorrhea in an adolescent. Amenorrhea occurred 2 months after starting sertraline, and menstrual cycle restored after stopping the treatment.
March 7, 2019: Clinical Neuropharmacology
María Andrea Camilletti, Alejandra Inés Abeledo Machado, Pablo Aníbal Pérez, Erika Yanil Faraoni, Fernanda De Fino, Susana B Rulli, Jimena Ferraris, Daniel Pisera, Silvina Gutiérrez, Peter Thomas, Graciela Diaz-Torga
Membrane progesterone receptors are known to mediate rapid nongenomic progesterone effects in different cell types. Recent evidence revealed that mPRα is highly expressed in the rat pituitary, being primarily localized in lactotrophs, acting as an intermediary of P4-inhibitory actions on prolactin secretion. The role of mPRs in prolactinoma development remains unclear. We hypothesize that mPR agonists represent a novel tool for hyperprolactinemia treatment. To this end, pituitary expression of mPRs was studied in three animal models of prolactinoma...
March 1, 2019: Endocrine-related Cancer
Xavier Boland, Preeti Chhabra
CASE SUMMARY: A 26-year-old man with a history of longstanding treatment-resistant schizophrenia gained a substantial amount of weight while being treated with high-dose combination antipsychotic therapy with olanzapine and amisulpride. The patient was switched to combination therapy with olanzapine and aripiprazole to reverse a drug-induced hyperprolactinemia. The patient subsequently lost over 37 lb in weight over a period of 4 months despite no measurable changes in his dietary caloric intake or in his level of physical activity and without any identifiable medical cause on physical investigation...
March 2019: Journal of Psychiatric Practice
José María Bonete Llácer, Alicia Martínez Hortelano, Begoña Richart Albelda
OBJECTIVES: Hyperprolactinemia (HPRL), defined as plasma prolactin (PRL) >25 ng/ml, is a frequent adverse effect of the treatment with some antipsychotics. The objectives of this study were to determine the prevalence of HPRL among schizophrenic patients treated with long-acting injectable (LAI) antipsychotic drugs at our hospital, and to estimate gender effects in PRL levels in these patients. METHODS: This cross-sectional, retrospective, study analyzed 165 psychotic patients treatment with LAI antipsychotics in monotherapy from February to May of 2017 at the Psychiatry Specialized Care Units of the Elche General Hospital (Spain)...
March 8, 2019: International Journal of Psychiatry in Clinical Practice
Mohamed M Aboelnaga, Eman H Eladawy, Maha M Elshafei, N Abdullah, M El Shaer
OBJECTIVE: We aimed in the current study to: 1) evaluate and compare metabolic and anthropometric profile in female patients with newly diagnosed prolactin secreting adenoma versus female idiopathic hyperprolactinemic patients 2) compare the effects of one year cabergoline therapy on the metabolic profile and anthropometric parameters (by using visceral adiposity index as index for evaluation of adipose tissue dysfunction) in female patients with prolactin secreting pituitary adenoma to female idiopathic hyperprolactinemic patients...
February 18, 2019: Endocrine, Metabolic & Immune Disorders Drug Targets
Yosra Moria, Rouba Kortbawi, Nadine El-Asmar, Baha M Arafah
BACKGROUND AND OBJECTIVES: Earlier studies suggested that hyperprolactinemia was associated with elevated serum DHEA-S levels. The importance of DHEA-S measurements in the diagnosis of adrenal insufficiency prompted us to assess adrenal androgen levels in hyperprolactinemic subjects with normal or impaired function. METHODS: Prospective study including 122 medically treated and 26 surgically patients with prolactinomas. Serum PRL, DHEA and DHEA-S levels were measured before and repeatedly after cabergoline therapy and also in the perioperative period of surgically treated patients...
February 23, 2019: Pituitary
Signe W Düring, Mette Ø Nielsen, Nikolaj Bak, Birte Y Glenthøj, Bjørn H Ebdrup
Sexual side-effects along with antipsychotic treatment may be linked to hyperprolactinemia and dopamine D2 receptor blockade. High prevalence of sexual dysfunction in un-medicated patients challenges the notion of sexual dysfunction as merely a side-effect of antipsychotic medication. Sexual dysfunction was assessed in fifty-six initially antipsychotic-naïve patients with schizophrenia using the UKU (Udvalget for Kliniske Undersøgelser) questionnaire. Serum-prolactin was obtained before and after six weeks of D2/3 receptor blockade with amisulpride...
February 8, 2019: Psychiatry Research
Kotaro Hatta, Hana Hasegawa, Atsushi Imai, Yasuhiko Sudo, Fumiyoshi Morikawa, Shigemasa Katayama, Haruo Watanabe, Takuya Ishizuka, Mitsuru Nakamura, Fuminari Misawa, Kiyoshi Fujita, Shigeru Ozaki, Kentaro Umeda, Hiroyuki Nakamura, Yutaka Sawa, Naoya Sugiyama
PURPOSE: The effectiveness of antipsychotic treatments in the acute phase of schizophrenia in actual clinical practice remains somewhat unclear. Therefore, the purpose of the present naturalistic, multi-center study conducted from 1 year starting in September 2017 was to examine the response rate to an initial or second antipsychotic in newly admitted patients with acute-phase schizophrenia, as well as the response rate and quality of augmentation with two antipsychotics in patients who failed to respond to both the initial and second antipsychotics...
February 8, 2019: Asian Journal of Psychiatry
Raluca Grădinaru, Nicoleta Andreescu, Laura Nussbaum, Liana Suciu, Maria Puiu
BACKGROUND: Treatment with atypical antipsychotics is today the election therapy for different types of psychosis, but there is a high incidence of endocrine and metabolic disturbances. One of the major enzymes involved in the metabolism of antipsychotics is CYP2D6. Depending on the existing CYP2D6 alleles, the metabolic capacity of the enzyme may vary from very low to very high, so that patients can be grouped into four phenotypic groups: slow, intermediate, extensive (normal), and fast metabolizers...
February 15, 2019: Irish Journal of Medical Science
Daniela Petrić, Valentino Rački, Nadija Gačo, Ana Kaštelan, Mirjana Graovac
OBJECTIVE: The aim of this study was to explore the effectiveness and tolerability of long-acting paliperidone palmitate antipsychotic in adolescent first-episode schizophrenia patients while comparing the results with the oral antipsychotic risperidone. METHODS: This study is a retrospective, noninterventional study to assess the effectiveness and tolerability of long-acting injectable antipsychotic paliperidone palmitate in first-episode adolescent patients during the first 12 months of treatment compared with the oral antipsychotic risperidone...
February 13, 2019: Journal of Child and Adolescent Psychopharmacology
X Du, R A Hill
The female hormone 17β-estradiol is postulated to be protective against schizophrenia onset and severity. Hypoestrogenism is a common phenomenon in women with schizophrenia that has serious effects that adds to the burden of an already very onerous disease. The cause of hypoestrogenism is largely attributed to antipsychotic-induced hyperprolactinemia. Evidence suggest however that a significant portion of female schizophrenia patients develop hypoestrogenism either before antipsychotic treatment or without regard to the level of prolactin, suggesting that for a sizeable segment of female patients, gonadal abnormality may be an innate and early aspect of the disease...
February 9, 2019: General and Comparative Endocrinology
Ying Guo, Yonggang Wang, Ming Ni, Yazhuo Zhang, Liyong Zhong
Objective To compare the effects of mass effects in situ (MEIS) and after neurosurgery (ANS) on neuroendocrine function in children with craniopharyngioma. Methods We retrospectively investigated 185 cases of children with craniopharyngioma who underwent neurosurgical treatment at the Beijing Tiantan Hospital from 2011 to 2016. The neuroendocrine function of patients was compared before and after tumor removal. Results Compared with the MEIS, the incidence of growth hormone insulin-like growth factor 1 axis dysfunction (47...
February 25, 2019: Journal of Pediatric Endocrinology & Metabolism: JPEM
Vânia Vieira Borba, Yehuda Shoenfeld
The sexual dimorphic prevalence of autoimmunity represents one of the most alluring observations among the mosaic of autoimmunity. Sex hormones are believed to be a mainstay of this asymmetry. The greater prevalence of autoimmunity among fertile women, disease onset/relapses during pregnancy, and postpartum are some of the points that support this theory. Undeniably, motherhood represents one of the most remarkable challenges for the immune system that not only has to allow for the conceptus but also deal with extraordinary hormonal alterations...
January 11, 2019: Clinical Rheumatology
Tanvi Sirohi, Harkaran Singh
Background: Hyperprolactinemia is a common endocrine disorder involving hypothalamic-pituitary axis. Prolactin (PRL) secretion is stimulated by dopamine antagonism and thyroid-releasing hormone. Hyperprolactinemia has been reported in subclinical hypothyroidism (SCH) but results are markedly variable and studies on SCH are very few. The objective of this study was to find out prevalence of hyperprolactinema in newly diagnosed subclinical hypothyroid patients. Materials and Methods: In this cross-sectional study, serum PRL levels of 150 newly diagnosed subclinical hypothyroid patients were determined using electrochemiluminescence method...
November 2018: Journal of Family Medicine and Primary Care
Jelena Ivkovic, Annika Lindsten, Vinu George, Hans Eriksson, Mary Hobart
BACKGROUND: Hyperprolactinemia is an undesirable effect of most antipsychotics because of D2-receptor blockade. We assessed the effect of the D2-receptor partial agonist brexpiprazole on prolactin, based on pooled data from three 6-week, randomized, placebo-controlled studies and two open-label extension studies in patients with schizophrenia. METHODS: In the short-term studies, patients received 0.25, 1, 2, 4 mg brexpiprazole or placebo; or flexible-dose brexpiprazole (2-4 mg/d), placebo, or active reference...
January 2019: Journal of Clinical Psychopharmacology
Yunqiao Zhang, Zhen Tang, Ye Ruan, Chaohong Huang, Jie Wu, Zixiang Lu, Wang Li, Yan Tang, Jianping Liu, Jixiang She, Ting Ting Wang, Yu Zhu, Zhao Wei Teng, Yong Zeng
BACKGROUND This study aimed to investigate the relationship between serum profiles of prolactin and thyroid stimulating hormone (TSH) and sexual dysfunction in patients with schizophrenia treated with conventional antipsychotic medication. MATERIAL AND METHODS A hospital-based cross-sectional study included 118 patients, age range 18-57 years (55 men, 63 women), with a confirmed diagnosis of schizophrenia. All patients were stable after antipsychotic treatment. Serum levels of hormones, including prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone, testosterone, thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3) and free thyroxine (FT4), were detected in venous blood...
December 16, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Paola Bozzatello, Silvio Bellino, Irene Mancini, Luisa Sandei, Enrico Zanalda, Paola Rocca
BACKGROUND AND OBJECTIVE: Clinical practice guidelines recommend antipsychotic monotherapy, including oral and long-acting formulations, in the treatment of schizophrenia. This open-label, randomized, controlled trial aimed to evaluate the efficacy and tolerability in patients with schizophrenia of once-monthly long-acting paliperidone palmitate (PP1M) compared with oral paliperidone extended release (ER), with a particular focus on satisfaction, subjective well-being, and service engagement. METHODS: Seventy-two consecutive outpatients with schizophrenia (DSM-5) were randomly assigned for 6 months to: (1) PP1M (50-150 mg equivalent) or (2) paliperidone ER (6-12 mg/day)...
December 6, 2018: Clinical Drug Investigation
Yu Peng Wu, Yi Bao Wang, Zhe Bao Wu
BACKGROUND: Germinomas are sensitive to radiotherapy and chemotherapy. However, there has been no report involving in the potential therapeutic effect of dopamine agonists (DAs) such as bromocriptine on germinomas. CASE DESCRIPTION: A 20-year-old female was presented with bitemporal visual disturbance and amenorrhea. Magnetic resonance imaging demonstrated a huge sellar tumor with upward extension and invasion of the parasellar region. The blood tests showed an exceedingly high level of prolactin...
November 10, 2018: Clinical Neurology and Neurosurgery
Robert Krysiak, Witold Szkróbka, Bogusław Okopień
BACKGROUND: Elevated prolactin levels are associated with increased cardiometabolic risk. No previous study has compared the effect of hypolipidemic therapy on plasma levels of lipids and other cardiometabolic risk factors in patients with and without hyperprolactinemia. METHODS: The study included three age-, weight-, blood pressure- and lipid-matched groups of premenopausal women: 18 women with untreated hyperprolactinemia, 19 women with bromocriptine-treated hyperprolactinemia and 20 drug-naïve women with normal prolactin levels...
September 6, 2018: Pharmacological Reports: PR
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