Influence of olanzapine on serum prolactin levels and BMI in female patients with schizophrenia

Yang, Fuyin; Chen, Lan; Fang, Xinyu; Zheng, Ke; Zhu, Cheng; Xu, Chaoqun; Zhang, Chen; Tang, Wei

doi:10.2147/ndt.s180303

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…The mechanism by which risperidone and olanzapine may increase the risk of cerebrovascular adverse events could be related to high levels of prolactin. Olanzapine and risperidone have been associated with high levels of prolactin[ 25 - 26 ]. High levels of prolactin have been associated with cerebrovascular events[ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Associated mortality risk of atypical antipsychotic medication in individuals with dementia

Phiri

Engelthaler²,

Carr

et al. 2022

WJP

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BACKGROUND Antipsychotic medications such as risperidone, olanzapine and aripiprazole are used to treat psychological and behavioural symptoms among dementia patients. Current evidence indicate prescription rates for antipsychotics vary and wider consensus to evaluate clinical epidemiological outcomes is limited. AIM To investigate the potential impact of atypical antipsychotics on the mortality of patients with dementia. METHODS A retrospective clinical cohort study was developed to review United Kingdom Clinical Record Interactive Search system based data between January 1, 2013 to December 31, 2017. A descriptive statistical method was used to analyse the data. Mini Mental State Examination (MMSE) scores were used to assess the severity and stage of disease progression. A cox proportional hazards model was developed to evaluate the relationship between survival following diagnosis and other variables. RESULTS A total of 1692 patients were identified using natural language processing of which, 587 were prescribed olanzapine, quetiapine or risperidone (common group) whilst 893 (control group) were not prescribed any antipsychotics. Patients prescribed olanzapine showed an increased risk of death [hazard ratio (HR) = 1.32; 95% confidence interval (CI): 1.08-1.60; P < 0.01], as did those with risperidone (HR = 1.35; 95%CI: 1.18-1.54; P < 0.001). Patients prescribed quetiapine showed no significant association (HR = 1.09; 95%CI: 0.90-1.34; P = 0.38). Factors associated with a lower risk of death were: High MMSE score at diagnosis (HR = 0.72; 95%CI: 0.62-0.83; P < 0.001), identifying as female (HR = 0.73; 95%CI: 0.64-0.82; P < 0.001), and being of a White-British ethnic group (HR = 0.82; 95%CI: 0.72-0.94; P < 0.01). CONCLUSION A significant mortality risk was identified among those prescribed olanzapine and risperidone which contradicts previous findings although the study designs used were different. Comprehensive research should be conducted to better assess clinical epidemiological outcomes associated with diagnosis and therapies to improve clinical management of these patients.

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Section: Discussionmentioning

confidence: 99%

Associated mortality risk of atypical antipsychotic medication in individuals with dementia

Phiri

Engelthaler²,

Carr

et al. 2022

WJP

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“…Normal prolactin levels range at 10–20 ng/ml for men and 10–25 ng/ml for women, although there is significant variability among different laboratories and studies (Peuskens et al, 2014). Furthermore, there are important interindividual differences (e.g., gender, age, stress, nutrition, and exercise) (Peuskens et al, 2014; Yang et al, 2018) and pronounced circadian variations (Peuskens et al, 2014). Hyperprolactinemia can be divided according to its severity: mild (50 ng/ml), moderate (51–75 ng/ml), and severe (>100 ng/ml) (Montejo et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Long-term hypogonadism due to hyperprolactinemia has also been associated with low bone density, osteoporosis, hip fracture (Yasui-Furukori et al, 2010; Pérez-Iglesias et al, 2012; Montejo et al, 2016), prolactinoma (Montejo et al, 2017), and increased cardiovascular risk (Montejo et al, 2016; Montejo et al, 2017). Women are considered to be more susceptible to be affected by antipsychotic-induced hyperprolactinemia; in spite of that, there is little literature reporting the trajectory of olanzapine-induced hyperprolactinemia in females (Yang et al, 2018). Preclinical animal models indicate that prolonged high levels of prolactin may predispose to breast cancer (Pérez-Iglesias et al, 2012); what is more, recent clinical studies have strengthened such association.…”

Section: Introductionmentioning

confidence: 99%

“…This elevation is regarded as transient and mild compared with that induced by other antipsychotics, such as risperidone (Yasui-Furukori et al, 2010; Montejo et al, 2016), with studies pointing that olanzapine does not significantly affect serum prolactin levels in the long term (Pérez-Iglesias et al, 2012; Montejo et al, 2016). There have been inconsistent results regarding the relationship between serum prolactin levels and doses/plasma concentrations of olanzapine (Peuskens et al, 2014; Takeuchi et al, 2014), although most studies have demonstrated a dose-dependent effect of oral olanzapine on the plasma prolactin level of patients with schizophrenia, with higher doses linked to higher prolactin levels (Peuskens et al, 2014; Takeuchi et al, 2014; Yang et al, 2018). All things considered, prolactin elevation induced by olanzapine remains an unclear matter (Yang et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…There have been inconsistent results regarding the relationship between serum prolactin levels and doses/plasma concentrations of olanzapine (Peuskens et al, 2014; Takeuchi et al, 2014), although most studies have demonstrated a dose-dependent effect of oral olanzapine on the plasma prolactin level of patients with schizophrenia, with higher doses linked to higher prolactin levels (Peuskens et al, 2014; Takeuchi et al, 2014; Yang et al, 2018). All things considered, prolactin elevation induced by olanzapine remains an unclear matter (Yang et al, 2018). Some D2 receptor and 5-HT2A receptor gene polymorphisms have been involved in prolactin levels after administration of olanzapine (Peuskens et al, 2014); DRD2 and ANKK1 polymorphisms have been associated with prolactin increase in olanzapine-treated women (Houston et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Olanzapine-Induced Hyperprolactinemia: Two Case Reports

et al. 2019

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Background: Hyperprolactinemia is a common consequence of treatment with antipsychotics. It is usually defined by a sustained prolactin level above the laboratory upper level of normal in conditions other than that where physiologic hyperprolactinemia is expected. Normal prolactin levels vary significantly among different laboratories and studies. Several studies indicate that olanzapine does not significantly affect serum prolactin levels in the long term, although this statement has been challenged. Aims: Our aim is to report two olanzapine-induced hyperprolactinemia cases observed in psychiatric consultations. Methods: Medical records of the patients who developed this clinical situation observed in psychiatric consultations in the Psychiatry Department of the Prof. Dr. Fernando Fonseca Hospital during the year of 2017 were analyzed, complemented with a non-systematic review of the literature. Results: The case reports consider two women who developed prolactin-related symptoms after the initiation of olanzapine. No baseline prolactinemia was obtained, and prolactin serum levels were only evaluated after prolactin-related symptoms developed: at the time of its measurement, both patients had been taking olanzapine for more than 24 weeks. Hyperprolactinemia was found to be present in Case 2, whereas Case 1 (a 49-year-old woman) had “normal” serum prolactin levels for premenopausal and prolactin levels slightly above the maximum levels for postmenopausal women. Both patients underwent similar pharmacological adjustments, which comprised switches from olanzapine to aripiprazole. After all pharmacological changes, prolactin serum levels decreased to normal range values and prolactin-related symptoms disappeared. Discussion/Conclusions: Laboratorial and literature prolactinemia values variability and discrepancies may make the management of borderline hyperprolactinemia clinical situations difficult. Baseline prolactin levels should have been obtained, as they help in the management of patients who develop neuroleptic-induced hyperprolactinemia. Prolactin-related symptoms can occur with borderline or normal standardized prolactinemia values. Olanzapine-induced hyperprolactinemia is a rare but possible event. Aripiprazole was used as a suitable alternative for olanzapine-induced hyperprolactinemia.

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Prolactin and human weight disturbances: A puzzling and neglected association

Sobrinho¹,

Horseman

2019

Rev Endocr Metab Disord

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Influence of olanzapine on serum prolactin levels and BMI in female patients with schizophrenia

Cited by 8 publications

References 31 publications

Associated mortality risk of atypical antipsychotic medication in individuals with dementia

Associated mortality risk of atypical antipsychotic medication in individuals with dementia

Olanzapine-Induced Hyperprolactinemia: Two Case Reports

Prolactin and human weight disturbances: A puzzling and neglected association

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