Drug-induced hyperprolactinemia: mechanism of development, features of diagnosis and treatment

Q3 Medicine

Obesity and Metabolism Pub Date : 2023-11-14 DOI:10.14341/omet13036

L. Dzeranova, S. Y. Vorotnikova, A. S. Shutova, E. A. Pigarova, M. I. Yevloyeva

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引用次数: 0

Abstract

One of the causes of non-tumor related hyperprolactinemia is taking a medications. Physicians of various specialties, such as cardiologists, gastroenterologists, endocrinologists, and neurologists, encounter hyperprolactinemia as a side effect of drug therapy in their practice, but it is most often observed in the practice of a psychiatrist when treating patients with psychotropic medications. Over the past few years, there has been an increase in the frequency of prescriptions of antidepressants and neuroleptics due to post-COVID-19 syndrome, anxiety and stress caused by the pandemic of a new coronavirus infection. There is also a predisposition to the development of hyperprolactinemia on the background of taking neuroleptics due to genetic features of patients. Currently, there is no established common algorithm for diagnosis and treatment of drug-induced hyperprolactinemia in the world. Based on a review of foreign and domestic literature, the article discusses in detail the mechanisms of development and various approaches to the correction of iatrogenic (drug-induced) hyperprolactinemia, assesses the prolactogenic activity of neuroleptics, and proposes algorithms for prolactin monitoring and correction of hyperprolactinemia using dopamine agonists. Often the tactics of management of such patients need to be discussed by a team of specialized physicians.

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药物诱发的高催乳素血症：发病机制、诊断和治疗特点

非肿瘤性高泌乳素血症的原因之一是服用药物。心脏科、消化科、内分泌科和神经科等不同专科的医生在工作中都会遇到高泌乳素血症这种药物治疗的副作用，但最常见的是精神科医生在治疗服用精神药物的病人时出现这种情况。在过去几年中，由于新型冠状病毒感染大流行导致的后 COVID-19 综合征、焦虑和压力，抗抑郁药和神经安定药的处方频率有所增加。此外，由于患者的遗传特征，在服用神经抑制剂的背景下也容易出现高泌乳素血症。目前，世界上对药物性高催乳素血症的诊断和治疗尚无统一的算法。本文在综述国内外文献的基础上，详细论述了先天性（药物诱发）高泌乳素血症的发病机制和各种纠正方法，评估了神经抑制剂的催乳活性，并提出了使用多巴胺激动剂监测泌乳素和纠正高泌乳素血症的算法。通常，这类患者的治疗策略需要由一组专业医生共同讨论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity and Metabolism Medicine-Internal Medicine

CiteScore

1.30

自引率

0.00%

发文量

期刊介绍： Journal "Obesity and Metabolism" is a multidisciplinary forum for clinical and applied research in the field of biochemistry, physiology, pathophysiology, genetics, nutrition, as well as molecular, metabolic, psychological and epidemiological aspects of obesity and metabolism. The main subject "Metabolism" reviewed in the journal, includes fat, carbohydrate, protein, bone, fluid and electrolyte and other types of metabolism in the spectrum of pathology of the endocrine system. The priority direction of Journal "Obesity and Metabolism" is publishing modern high-quality original research on the effectiveness of new and existing treatments in any aspect of metabolic and endocrine diseases. Pre-clinical pharmacology, pharmacokinetics studies, meta-analyzes, addressed to drug safety and tolerance are also welcome for publication in the journal "Obesity and metabolism." Journal "Obesity and Metabolism" announces review articles that are balanced, clear and offer the reader a modern and critical analysis of the literature on the subject of the magazine. Case reports, and lecture materials are also published for highlighting for practitioners new approaches to diagnosis and treatment of patients with metabolic disorders and obesity.