Effects of aripiprazole on prolactin levels in subjects with schizophrenia during cross-titration with risperidone or olanzapine: Analysis of a randomized, open-label study

Byerly, Matthew J.; Marcus, Ronald N.; Tran, Quynh-Van; Eudicone, James M.; Whitehead, Richard; Baker, Ross A.

doi:10.1016/j.schres.2008.09.019

Cited by 75 publications

(61 citation statements)

References 19 publications

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“…72,104 Open label studies 98 reported improved sexual functioning for adjunctive therapy with aripiprazole, [104][105][106] vardenafil, 108 peony-glycyrrhiza-decoction, 109 carbegoline, 110 amantadine, 111,112 shakuyaku-kanzo-to 113 , and imipramine. 114 Open label studies described improvement in sexual performance when switching from antipsychotics that are strong dopamine antagonists (which often lead to elevated prolactin levels) to aripiprazole, 105,[115][116][117] ziprasidone, 118,119 olanzapine [120][121][122][123] , and quetiapine 124,125 (prolactin sparing antipsychotics); the switch to aripiprazole was the most studied strategy. 98 In summary, strategies to treat antipsychotic-induced sexual dysfunction include lowering the dose, switching to a prolactin sparing antipsychotic, adding a dopamine agonist, aripiprazole, or a PDE-5-inhibitor.…”

Section: Pharmacological Treatment Strategies For Antipsychotic-inducmentioning

confidence: 99%

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Boer

Castelein

Wiersma

et al. 2015

Schizophrenia Bulletin

140

115

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A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α 1 -receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce.

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Section: Pharmacological Treatment Strategies For Antipsychotic-inducmentioning

confidence: 99%

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Boer

Castelein

Wiersma

et al. 2015

Schizophrenia Bulletin

140

115

View full text Add to dashboard Cite

show abstract

“…However, they abandoned their plan to completely discontinue the causative drugs during the study because half of the patients attained subjective satisfaction with the combination of aripiprazole and their previous antipsychotic medications. Meanwhile, 3 [14][15][16] of 4 previous studies on switching to aripiprazole noted that the prolactin concentrations decreased during the combination period. The present subjects might be heterogeneous, since 10 patients received 7 different types (or combinations thereof) of antipsychotics and 4 different doses of adjunctive aripiprazole.…”

Section: Discussionmentioning

confidence: 97%

“…Previous studies [13][14][15][16] have shown that switching from prolactin-raising antipsychotics to aripiprazole is useful for treating antipsychotic-induced hyperprolactinemia in schizophrenic patients, with no significant changes in overall psychopathology. However, clinicians generally hesitate to change antipsychotic regimens, especially in clinically stable patients maintaining a high level of functioning, since such a strategy is sometimes accompanied by the risk that psychotic symptoms may worsen later.…”

Section: Discussionmentioning

confidence: 99%

Improvement in antipsychotic-induced hyperprolactinemia with the addition of aripiprazole in schizophrenic patients

Mihara

Nagai

Nakamura

et al. 2010

CNPT

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Purpose: Hyperprolactinemia, a common adverse effect of antipsychotics, frequently impacts patients' quality of life. Aripiprazole is a potent dopamine D2 receptor partial agonist and rarely increases the serum prolactin concentration. The authors investigated the effect of aripiprazole coadministration on antipsychotic-induced hyperprolactinemia and associated symptoms in patients with schizophrenia. Method: The subjects were 9 patients (8 females, 1 male) with hyperprolactinemia induced by risperidone, olanzapine, haloperidol, zotepine, bromperidol, levomepromazine, and quetiapine; 6 of the females had oligomenorrhea and 2 amenorrhea, and the male had erectile dysfunction. All of the patients received concomitant aripiprazole for more than 8 weeks at a mean dose (range) of 7.7 (3-18) mg/day. The doses of all other medications, including the hyperprolactinemia-inducing antipsychotics, remained fixed throughout the study period. Results: The mean serum concentration (range) of prolactin during aripiprazole coadministration (29.9 (9.8-53) ng/ml) was significantly (p=0.008) lower than that before aripiprazole coadministration (81.1 (27-153) ng/ml). The associated symptoms were improved in 4 females (regularized or regained menstruation) and the male (normalized erectile function), while no changes were observed in the other clinical symptoms of schizophrenia. Discussion: The results of the present study suggest that even small doses of coadministered aripiprazole effectively limit excessive prolactin response to antipsychotics without interfering with the benefits of existing prescriptions.

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“…Aripiprazole appears to produce significant reductions in hyperprolactinemia while maintaining therapeutic efficacy for psychosis. Though this effect on hyperprolactinemia is inconsistent [34,35].…”

Section: Discussionmentioning

confidence: 99%

Light and electron microscopic study on the effect of antischizophrenic drugs on the structure of seminiferous tubules of adult male albino rats

Soliman

Wagih

Attia

et al. 2015

Folia Histochem Cytobiol.

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Introduction. Sexual dysfunction and infertility are symptoms which have been rarely studied in patients treated with antischizophrenic drugs, aripiprazole and olanzapine, for long period. This work aimed to investigate the effects of aripiprazole and olanzapine on the structure of seminiferous tubules of rats at both light microscopic and ultrastructural levels. Material and methods. Sixty adult male rats were divided into 3 groups (n = 20): control group (Group I) and two experimental ones (II and III). Rats in Group II received 2 mg/kg/day aripiprazole while rats in Group III received 0.5 mg/kg/day olanzapine for 14 weeks. Thereafter, testis were removed and processed for both light and electron microscopic study. Qualitative morphological analyses and histomorphometric measurements of seminiferous tubules were performed. Results. Rats in Group II showed reduction of testicular weight, seminiferous tubules' diameter, epithelial height, spermatogenic count, spermatogenic index and spermatogenic score whereas Sertoli cells count was increased. Olanzapine-treated rats also showed epithelial desquamation, separation and apoptotic changes of germ cells. Sertoli cells showed vacuolization, dilatation of smooth endoplasmic reticulum and accumulation of lipid droplets. Abnormality in the shape and structure of late spermatids and presence of giant cells were also demonstrated. Aripiprazole induced less adverse histological changes in rat testis than olanzapine. Conclusions. Olanzapine followed by aripiprazole had adverse histological effects on the structure of the seminiferous tubules, which may affect spermatogenesis.

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Effects of aripiprazole on prolactin levels in subjects with schizophrenia during cross-titration with risperidone or olanzapine: Analysis of a randomized, open-label study

Cited by 75 publications

References 19 publications

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

Improvement in antipsychotic-induced hyperprolactinemia with the addition of aripiprazole in schizophrenic patients

Light and electron microscopic study on the effect of antischizophrenic drugs on the structure of seminiferous tubules of adult male albino rats

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