Sex differences in changes in prolactin levels and sexual function after switching from risperidone to paliperidone palmitate in schizophrenia

IF 2.5 4区 医学 Q2 PSYCHIATRY
Meritxell Tost , Juan David Barbero , Itziar Montalvo , Alexandre González-Rodríguez , Raquel Aguayo , Aida Álvarez , Rosa Gabernet , Eduard Izquierdo , Igor Merodio , Siddarta Acebillo , Diego Palao , Javier Labad
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引用次数: 0

Abstract

Background and objectives

Hyperprolactinaemia is a significant side effect of antipsychotic medications and may cause sexual dysfunction. Although risperidone and paliperidone can induce prolactin elevation, previous studies suggest that switching from risperidone long-acting injectable (LAI) to paliperidone palmitate (PP) might reduce prolactin concentrations in early psychosis patients. We aimed to evaluate the effect of switching from risperidone to PP on sexual functionality and prolactin levels in patients with schizophrenia.

Methods

We studied 38 patients with schizophrenia who were treated with risperidone (oral or R-LAI) monotherapy at stable doses for at least two months and had an indication to be switched to PP by their psychiatrists. Three assessments were completed: 1) baseline (preswitch), 2) 3 months post-switch, and 3) 6 months post-switch. Prolactin concentrations in plasma were determined. Sexual functioning was assessed with the Arizona Sexual Experience Scale (ASEX). Statistical analyses were conducted in 27 patients who had at least one follow-up visit. Longitudinal changes in prolactin levels and sexual function after switching from risperidone to PP were analysed with linear mixed models. Significance was set at p < 0.05.

Results

Prolactin concentrations were reduced in women after the switch, with a significant time by sex effect (p = 0.035). Antipsychotic doses influenced prolactin levels (p = 0.006), such that higher antipsychotic doses were associated with higher prolactin concentrations. No significant differences were found in ASEX total scores at 6 months after the switch.

Conclusions

In patients with schizophrenia, switching from risperidone to PP was associated with a reduction in prolactin concentrations in women but not men.

精神分裂症患者从利培酮转用帕利哌酮棕榈酸酯后催乳素水平和性功能变化的性别差异
背景和目的高催乳素血症是抗精神病药物的一个重要副作用,可能导致性功能障碍。尽管利培酮和帕利哌酮可引起催乳素升高,但以往的研究表明,将利培酮长效注射剂(LAI)换成棕榈酸帕利哌酮(PP)可能会降低早期精神病患者的催乳素浓度。我们的目的是评估从利培酮改用 PP 对精神分裂症患者性功能和催乳素水平的影响。方法我们研究了 38 名精神分裂症患者,他们接受利培酮(口服或 R-LAI)单药治疗,剂量稳定至少两个月,精神科医生建议他们改用 PP。该研究完成了三项评估1)基线(转换前);2)转换后 3 个月;3)转换后 6 个月。测定血浆中催乳素的浓度。性功能采用亚利桑那性体验量表 (ASEX) 进行评估。对至少进行过一次随访的 27 名患者进行了统计分析。采用线性混合模型分析了从利培酮改用PP后催乳素水平和性功能的纵向变化。结果女性患者在改用PP后泌乳素浓度降低,性别对时间的影响显著(p = 0.035)。抗精神病药物剂量影响泌乳素水平(p = 0.006),因此抗精神病药物剂量越大,泌乳素浓度越高。结论 在精神分裂症患者中,从利培酮转用PP与女性催乳素浓度的降低有关,但与男性无关。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
40
审稿时长
43 days
期刊介绍: The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.
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