抗精神病药物对青少年精神疾病患者催乳素水平的影响：一项横断面研究。

IF 5.3 2区医学 Q1 CLINICAL NEUROLOGY

Progress in Neuro-Psychopharmacology & Biological Psychiatry Pub Date : 2025-04-02 DOI:10.1016/j.pnpbp.2025.111349

Shuhei Wada , Kunihiro Iwamoto , Akira Yoshimi , Hirotake Hida , Shogo Hotta , Yukihiro Noda , Masashi Ikeda

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引用次数: 0

摘要

目的：儿童和青少年抗精神病药物处方的增加引起了对催乳素水平异常的关注。然而，很少进行催乳素监测（0.1-10 %），催乳素水平异常的患病率和特征尚不清楚。本研究旨在调查在现实世界的临床环境中接受抗精神病药物治疗的儿童和青少年患者血清催乳素水平异常的患病率，并确定影响催乳素水平的因素。方法：在名古屋大学医院进行回顾性横断面研究，纳入连续489例老年精神疾病患者。结果：23.0% %的抗精神病药物治疗患者出现高催乳素血症，13.7% %的患者出现低催乳素血症。多潘立酮、舒必利和抗精神病药物显著增加催乳素水平。利培酮、奥氮平和勃兰色林与血清催乳素水平显著升高相关，而阿立哌唑与低催乳素血症相关。结论：约40% %的儿童患者在接受抗精神病药物治疗后出现催乳素水平异常。临床医生在给儿童和青少年开抗精神病药时应常规监测催乳素水平，并考虑催乳素相关的副作用。这些发现强调了定制抗精神病药物治疗的重要性，以尽量减少这一弱势群体的不良反应。

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Impact of antipsychotics on prolactin levels in youth with psychiatric disorders: A cross-sectional study

Objective

The increasing prescription of antipsychotics for children and adolescents raises concerns regarding abnormal prolactin levels. However, prolactin monitoring is rarely conducted (0.1–10 %), and the prevalence and characteristics of abnormal prolactin levels remain unclear. This study aimed to investigate the prevalence of abnormal prolactin levels and identify the factors influencing serum prolactin levels in pediatric and adolescent patients treated with antipsychotics in a real-world clinical setting.

Method

This retrospective cross-sectional study was conducted at Nagoya University Hospital and included consecutive 489 patients with psychiatric disorders aged <18 years who underwent serum prolactin monitoring. Because all hospitalized patients were included, sampling bias was minimized. Data on patient demographics, psychiatric diagnoses, medications, and prolactin levels were extracted and analyzed. Multiple regression analysis was performed to identify the factors influencing serum prolactin levels. Analysis of covariance was used to assess the effects of different antipsychotics on prolactin levels.

Results

Hyperprolactinemia was observed in 23.0 % of patients treated with antipsychotics, whereas hypoprolactinemia was observed in 13.7 % of patients. Domperidone, sulpiride, and antipsychotics significantly increased prolactin levels. Risperidone, olanzapine, and blonanserin were associated with significantly increased serum prolactin levels, whereas aripiprazole was associated with hypoprolactinemia.

Conclusion

Approximately 40 % of pediatric patients treated with antipsychotics exhibited abnormal prolactin levels. Clinicians should routinely monitor prolactin levels and consider prolactin-related side effects when prescribing antipsychotics to children and adolescents. These findings emphasize the importance of tailored antipsychotic therapy to minimize the adverse effects in this vulnerable population.

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来源期刊

Progress in Neuro-Psychopharmacology & Biological Psychiatry 医学-精神病学

CiteScore

12.00

自引率

1.80%

发文量

153

审稿时长

56 days

期刊介绍： Progress in Neuro-Psychopharmacology & Biological Psychiatry is an international and multidisciplinary journal which aims to ensure the rapid publication of authoritative reviews and research papers dealing with experimental and clinical aspects of neuro-psychopharmacology and biological psychiatry. Issues of the journal are regularly devoted wholly in or in part to a topical subject. Progress in Neuro-Psychopharmacology & Biological Psychiatry does not publish work on the actions of biological extracts unless the pharmacological active molecular substrate and/or specific receptor binding properties of the extract compounds are elucidated.