{"title":"Hyperprolactinemia is a Major Problem in Patients Treated with Antipsychotic Drugs","authors":"K. Baskoy, S. Ay, F. Deniz, A. Yonem","doi":"10.5455/BCP.20151209125410","DOIUrl":null,"url":null,"abstract":"We have read with great interest the article “Relationship between plasma levels of prolactin and the severity of negative symptoms in patients with schizophrenia” written by Ates et al.. They aimed to investigate the relationship between prolactin levels of plasma and negative symptoms in patients with schizophrenia. They demonstrated that prolactin levels are positively correlated with the severity of negative symptoms. We would like to thank to the authors for their contribution of the present study, which is successfully designed and documented. In Ates et al’s article, the authors mentioned that gonadal steroids could play a significant role in the pathophysiology and could affect the course of schizophrenia. Additionally, it is known as classically, hyperprolactinemia is associated with disturbances in the levels of key reproductive hormones. For instance, Hyperprolactinemia inhibiting the effect of FSH and LH could decrease the levels of testosterone and estradiol. Although, there is a relationship between gonadal s t e r o i d s a n d b o t h h y p e r p r o l a c t i n e m i a a n d schizophrenia, researchers in this study did not consider the levels of testosterone, estradiol, FSH, and LH. Hence, the results might be different if the authors had mentioned those factors in their study. Prolactin exists in different forms in circulation as monomeric, dimeric, and polymeric. While the monomeric form, defined biologically active, constitutes the majority of total prolactin; the polymeric form defined macroprolactin and accepted biologically inactive is a complex of monomeric p r o l a c t i n w i t h I g G . M a c r o p r o l a c t i n e m i a i s characterized by excess of macroprolactin levels and seen 10-25% in patients with hyperprolactinaemia. This condition does not require any treatment, since it is not clinically significant. Another important issue in the differential diagnosis of hyperprolactinemia is to investigate the drug induced hyperprolactinemia such as metoclopramide, domperidone, and verapamil. This situation is quite often seen in clinical practice. Therefore, establishing of macroprolactinemia and drugs increasing the prolactin levels is quite important to avoid the misdiagnosis and overtreatments in patients with hyperprolactinemia. In conclusion, it is a pleasure for us to see that physicians not primarily involved in endocrinology field are also aware of hyperprolactinemia and its association with psychiatric disorders and medications. So, it would have been better if these additional crucial factors were included in the paper.","PeriodicalId":17852,"journal":{"name":"Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Klinik Psikofarmakoloji Bulteni-bulletin of Clinical Psychopharmacology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5455/BCP.20151209125410","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
We have read with great interest the article “Relationship between plasma levels of prolactin and the severity of negative symptoms in patients with schizophrenia” written by Ates et al.. They aimed to investigate the relationship between prolactin levels of plasma and negative symptoms in patients with schizophrenia. They demonstrated that prolactin levels are positively correlated with the severity of negative symptoms. We would like to thank to the authors for their contribution of the present study, which is successfully designed and documented. In Ates et al’s article, the authors mentioned that gonadal steroids could play a significant role in the pathophysiology and could affect the course of schizophrenia. Additionally, it is known as classically, hyperprolactinemia is associated with disturbances in the levels of key reproductive hormones. For instance, Hyperprolactinemia inhibiting the effect of FSH and LH could decrease the levels of testosterone and estradiol. Although, there is a relationship between gonadal s t e r o i d s a n d b o t h h y p e r p r o l a c t i n e m i a a n d schizophrenia, researchers in this study did not consider the levels of testosterone, estradiol, FSH, and LH. Hence, the results might be different if the authors had mentioned those factors in their study. Prolactin exists in different forms in circulation as monomeric, dimeric, and polymeric. While the monomeric form, defined biologically active, constitutes the majority of total prolactin; the polymeric form defined macroprolactin and accepted biologically inactive is a complex of monomeric p r o l a c t i n w i t h I g G . M a c r o p r o l a c t i n e m i a i s characterized by excess of macroprolactin levels and seen 10-25% in patients with hyperprolactinaemia. This condition does not require any treatment, since it is not clinically significant. Another important issue in the differential diagnosis of hyperprolactinemia is to investigate the drug induced hyperprolactinemia such as metoclopramide, domperidone, and verapamil. This situation is quite often seen in clinical practice. Therefore, establishing of macroprolactinemia and drugs increasing the prolactin levels is quite important to avoid the misdiagnosis and overtreatments in patients with hyperprolactinemia. In conclusion, it is a pleasure for us to see that physicians not primarily involved in endocrinology field are also aware of hyperprolactinemia and its association with psychiatric disorders and medications. So, it would have been better if these additional crucial factors were included in the paper.
我们饶有兴趣地阅读了Ates等人的文章《精神分裂症患者血浆催乳素水平与阴性症状严重程度的关系》。他们的目的是研究精神分裂症患者血浆催乳素水平与阴性症状之间的关系。他们证明催乳素水平与阴性症状的严重程度呈正相关。我们要感谢作者对本研究的贡献,这是成功的设计和记录。在Ates等人的文章中,作者提到性腺类固醇在病理生理中发挥重要作用,并可能影响精神分裂症的病程。此外,众所周知,高催乳素血症与关键生殖激素水平的紊乱有关。例如,高催乳素血症抑制FSH和LH的作用,可以降低睾酮和雌二醇的水平。虽然,性腺激素水平与抑郁症、抑郁症和精神分裂症之间存在一定的关系,但研究人员在本研究中并未考虑睾酮、雌二醇、卵泡刺激素和黄体生成素的水平。因此,如果作者在他们的研究中提到这些因素,结果可能会有所不同。催乳素以不同的形式存在于循环中,有单体、二聚体和聚合物。虽然被定义为生物活性的单体形式构成了总催乳素的大部分;定义的聚合形式macroprolactin并接受生物活性是一个复杂的单体的p r l c o t我n w t h g g。高泌乳素血症患者中有10-25%的高泌乳素血症患者以高泌乳素血症为特征。这种情况不需要任何治疗,因为它没有临床意义。高催乳素血症鉴别诊断的另一个重要问题是探讨药物引起的高催乳素血症,如甲氧氯普胺、多潘立酮和维拉帕米。这种情况在临床实践中很常见。因此,建立高催乳素血症和提高催乳素水平的药物对于避免高催乳素血症患者的误诊和过度治疗是非常重要的。总之,我们很高兴地看到,不是主要从事内分泌学领域的医生也意识到高泌乳素血症及其与精神疾病和药物的关系。因此,如果这些额外的关键因素包括在论文中,那就更好了。