Decreased Plasma Prolactin Release in Euthymic Lithium-Treated Women with Bipolar Disorder

Khoury, Aram El; Tham, Anne; Mathé, Aleksander A.; Åberg‐Wistedt, Anna; Stain-Malmgren, Rigmor

doi:10.1159/000071823

Cited by 15 publications

(10 citation statements)

References 33 publications

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“…In bipolar disorder, in addition to APS, another type of drug is usually used, such as a mood stabilizer or antidepressant. In the case of mood stabilizers, there are data to indicate that valproate does not seem to affect PRL levels in male patients (Aldemir et al 2012) and that lithium may even have a lowering effect on PRL levels both in female (El Khoury et al 2003) and male (Bastürk et al 2001) patients (LE: IIb). With respect to antidepressants, there are more than 40 hyperprolactinemia reports in patients treated with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, although there is only one ad hoc study in the case of fluoxetine (which was associated with hyperprolactinemia in 12.5% of patients of the study, 4.5% of male patients and 22.2% of female patients) (Papakostas, 2006) and sertraline, with negative results in female patients (Sagud et al 2002) (LE: III).…”

Section: Bipolar Disordermentioning

confidence: 99%

Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics

Montejo

Arango

Bernardo

et al. 2017

Frontiers in Neuroendocrinology

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Hyperprolactinemia is an underappreciated/unknown adverse effects of antipsychotics. The consequences of hyperprolactinemia compromise therapeutic adherence and can be serious. We present the consensus recommendations made by a group of experts regarding the management of antipsychotic-induced hyperprolactinemia. The current consensus was developed in 3 phases: 1, review of the scientific literature; 2, subsequent round table discussion to attempt to reach a consensus among the experts; and 3, review by all of the authors of the final conclusions until reaching a complete consensus. We include recommendations on the appropriate time to act after hyperprolactinemia detection and discuss the evidence on available options: decreasing the dose of the antipsychotic drug, switching antipsychotics, adding aripiprazole, adding dopaminergic agonists, and other type of treatment. The consensus also included recommendations for some specific populations such as patients with a first psychotic episode and the pediatric-youth population, bipolar disorder, personality disorders and the elderly population.

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Section: Bipolar Disordermentioning

confidence: 99%

Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics

Montejo

Arango

Bernardo

et al. 2017

Frontiers in Neuroendocrinology

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“…In a recent case-control study, PTH and ionized calcium levels were significantly higher in Li-exposed patients, and the proportions of subjects with hyperparathyroidism (8.6 %) and hypercalcaemia (24.1 %) were significantly greater in Liexposed patients [65]. Li may constitute a safe option in BD patients with high risk of hyperprolactinemia, considering that it lowers serum prolactin levels, especially during long-term treatment [66,67].…”

Section: Lithiummentioning

confidence: 94%

Management of Adverse Effects of Mood Stabilizers

Murru

Popović

Pacchiarotti

et al. 2015

Curr Psychiatry Rep

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Mood stabilizers such as lithium and anticonvulsants are still standard-of-care for the acute and long-term treatment of bipolar disorder (BD). This systematic review aimed to assess the prevalence of their adverse effects (AEs) and to provide recommendations on their clinical management. We performed a systematic research for studies reporting the prevalence of AEs with lithium, valproate, lamotrigine, and carbamazepine/oxcarbazepine. Management recommendations were then developed. Mood stabilizers have different tolerability profiles and are eventually associated to cognitive, dermatological, endocrine, gastrointestinal, immunological, metabolic, nephrogenic, neurologic, sexual, and teratogenic AEs. Most of those can be transient or dose-related and can be managed by optimizing drug doses to the lowest effective dose. Some rare AEs can be serious and potentially lethal, and require abrupt discontinuation of medication. Integrated medical attention is warranted for complex somatic AEs. Functional remediation and psychoeducation may help to promote awareness on BD and better medication management.

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“…Most controlled studies have indirectly associated lithium with glucose intolerance or even diabetes, being this effect attributed to the weight gain secondary to the medication use 77,79 . Lithium may reduce the serum prolactin levels, unlike most other psychotropics 80,81 . Hypermagnesemia is also often associated with the use of lithium, reaching 30% of patients 41 .…”

Section: Additional Laboratorial and Imaging Findingsmentioning

confidence: 98%

Lithium safety and tolerability in mood disorders: a critical review

Aprahamian¹,

Sousa²,

Valiengo³

et al. 2014

Rev. psiquiatr. clín.

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Background: Lithium is a first-line treatment for bipolar disorder in all phases, also indicated as add-on drug for unipolar depression and suicide prevention. This study encompasses a broad critical review on the safety and tolerability of lithium for mood disorders. Methods: A computerized search for English written human studies was made in MEDLINE, using the keywords "lithium" and "mood disorders", starting from July 1993 through July 2013 (n = 416). This initial search aimed to select clinical trials, prospective data, and controlled design studies of lithium treatment for mood disorders reporting adverse effects (n = 36). The final selection yielded 91 studies. Results: The most common general side effects in patients on lithium treatment were thirst, frequent urination, dry mouth, weight gain, fatigue and cognitive complaints. Lithium users showed a high prevalence of hypothyroidism, hyperparathyroidism, and decrease in urinary concentration ability. Reduction of glomerular filtration rate in patients using lithium was also observed, but in a lesser extent. The evidence of teratogenicity associated with lithium use is not well established. Anti-inflammatory non-steroidal drugs, thiazide diuretics, angiotensin-converting enzyme inhibitors, and alprazolam may increase serum lithium and the consequent risk for intoxication. Discussion: Short-term lithium treatment is associated with mild side effects. Medium and long-term lithium treatment, however, might have effects on target organs which may be prevented by periodical monitoring. Overall, lithium is still a safe option for the treatment of mood disorders.

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Decreased Plasma Prolactin Release in Euthymic Lithium-Treated Women with Bipolar Disorder

Cited by 15 publications

References 33 publications

Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics

Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics

Management of Adverse Effects of Mood Stabilizers

Lithium safety and tolerability in mood disorders: a critical review

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