Clinical outcomes and serum prolactin levels in patients with antipsychotic-induced hyperprolactinemia following different management strategies.

IF 2.3 4区医学 Q2 PSYCHIATRY

International Journal of Psychiatry in Clinical Practice Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI:10.1080/13651501.2025.2593315

Apiradee Sangngarm, Chompoonuch Werawattanachai, Kamonrat Somrak, Sipanut Silaket, Tuanthon Boonlue

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Abstract

Objective: To evaluate the effects of different management strategies (watchful waiting, dose reduction, switching and adjunctive treatments) on prolactin levels and clinical outcomes in patients with antipsychotic-induced hyperprolactinaemia.

Methods: A prospective cohort study was conducted with 135 adult patients diagnosed with hyperprolactinaemia due to antipsychotic use. Patients were assigned to four management groups: watchful waiting, dose reduction, switching and adjunctive treatment (with aripiprazole). Prolactin levels and clinical symptoms (e.g. galactorrhea, gynaecomastia, menstrual irregularities) were assessed before and after intervention.

Results: Baseline prolactin levels were comparable across groups. Post-intervention, all groups exhibited significant reductions in prolactin levels, with the largest decrease observed in the switching and adjunctive treatment group (mean change: -68.3 and -67.1 ng/mL, respectively). Clinical outcomes also improved, with a notable reduction in galactorrhea (p = 0.04), gynaecomastia (p = 0.004) and menstrual irregularities across all groups (p = 0.02). No significant changes were observed in sexual dysfunction, hirsutism or acne.

Conclusion: Management strategies for antipsychotic-induced hyperprolactinaemia, particularly switching or adjunctive treatments, effectively reduce prolactin levels and improve related symptoms.

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抗精神病药致高催乳素血症患者不同治疗策略后的临床结果和血清催乳素水平。

目的：评价不同治疗策略（观察等待、减量、切换及辅助治疗）对抗精神病药致高催乳素血症患者催乳素水平及临床转归的影响。方法：对135例因使用抗精神病药物而被诊断为高泌乳素血症的成年患者进行前瞻性队列研究。将患者分为观察等待组、减量组、转换组和辅助治疗组（阿立哌唑）。在干预前后评估催乳素水平和临床症状（如溢乳、妇科乳房发育、月经不规律）。结果：各组间基线催乳素水平具有可比性。干预后，所有组的催乳素水平均显著降低，其中切换和辅助治疗组下降幅度最大（平均变化分别为-68.3和-67.1 ng/mL）。临床结果也有所改善，所有组的溢乳（p = 0.04）、妇科乳房发育（p = 0.004）和月经不规律（p = 0.02）均显著减少。在性功能障碍、多毛症或痤疮方面没有观察到明显的变化。结论：抗精神病性高催乳素血症的治疗策略，特别是转换或辅助治疗，可有效降低催乳素水平，改善相关症状。

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

International Journal of Psychiatry in Clinical Practice 医学-精神病学

CiteScore

6.00

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： International Journal of Psychiatry in Clinical Practice provides an international forum for communication among health professionals with clinical, academic and research interests in psychiatry. The journal gives particular emphasis to papers that integrate the findings of academic research into realities of clinical practice. Focus on the practical aspects of managing and treating patients. Essential reading for the busy psychiatrist, trainee and interested physician. Includes original research papers, comprehensive review articles and short communications. Key words: Psychiatry, Neuropsychopharmacology, Mental health, Neuropsychiatry, Clinical Neurophysiology, Psychophysiology, Psychotherapy, Addiction, Schizophrenia, Depression, Bipolar Disorders and Anxiety.