Evidence for the partial dopamine-receptor agonist aripiprazole as a first-line treatment of psychosis in patients with iatrogenic or tumorogenic hyperprolactinemia.

Abstract:

BACKGROUND:Antipsychotic drugs have many side effects, including elevation of prolactin levels through tuberoinfundibular dopamine-receptor blockade. Although a number of studies claim that aripiprazole is a prolactin-sparing antipsychotic drug that may even lower prolactin levels, there has not been an exhaustive evaluation of this claim. OBJECTIVE:The authors analyzed the burgeoning literature suggesting that aripiprazole is efficacious in treating iatrogenic and tumorogenic hyperprolactinemia. METHOD:The authors conducted a literature search for case studies, reports, and placebo-controlled trials that measured prolactin levels in adult patients taking aripiprazole. RESULTS:The search identified 17 studies, in which 3,489 psychotic patients were given aripiprazole alone, as an adjuvant to haloperidol or risperidone, or to treat psychosis with a concomitant prolactinoma. Across all studies, aripiprazole lowered prolactin levels an average of 74.3%, even in psychotic patients with prolactinoma, whereas haloperidol and risperidone increased prolactin levels by as much as 272%. CONCLUSION:These findings suggest that aripiprazole may play an important niche role in treating psychotic patients sensitive to elevated prolactin and patients with prolactin-secreting pituitary tumors.

journal_name

Psychosomatics

journal_title

Psychosomatics

authors

Hoffer ZS,Roth RL,Mathews M

doi

10.1176/appi.psy.50.4.317

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

317-24

issue

4

eissn

0033-3182

issn

1545-7206

pii

S0033-3182(09)70814-X

journal_volume

50

pub_type

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