Plasma prolactin response to domperidone in acute schizophrenia and schizophreniform illness

Nerozzi, Dina; Magnani, Armando; Sforza, Vincenzo; Scaramucci, Elena; Cerilli, Marco; Moretti, Costanzo; Frajese, Gaetano; Antonozzi, I.; Meltzer, Herbert Y.

doi:10.1016/0165-1781(90)90015-w

Cited by 8 publications

(5 citation statements)

References 18 publications

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“…The concomitant action of dopamine on the two pathways has been demonstrated in the action of apomorphine, also a DRD2 agonist [ 37 , 38 ]. Lower PRL has been related to more psychotic symptoms [ 17 , 18 , 23 , 24 , 39 , 40 ]. Hence, an abrupt lowering of PRL to an abnormally low level could be considered as a biomarker or warning sign for relapse in psychosis.…”

Section: Discussionmentioning

confidence: 99%

Abnormally low prolactin levels in schizophrenia patients after switching to aripiprazole in a randomized trial: a biomarker for rebound in psychotic symptoms?

et al. 2020

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Background Switching to aripiprazole from other antipsychotics can avoid antipsychotic-induced hyperprolactinemia but may result in an abnormally low prolactin level. This study aimed to assess whether the aripiprazole-induced abnormally low prolactin level was a biomarker for subsequent rebound of positive symptoms in schizophrenia patients. Methods Participants were 63 patients in an 8-week trial of switching to aripiprazole, in which preswitching antipsychotics were maintained for the first 2 weeks and aripiprazole was fixed at 15 mg orally throughout the trial. A prolactin level of < 3.7 ng/ml was defined as abnormally low, and an increase of two or more points in the positive subscore of the Positive and Negative Syndrome Scale at two adjacent ratings was defined as a psychotic rebound. Results Among 63 patients, 25 (39.7%) had an abnormally low prolactin level and 21 (33.3%) had a psychotic rebound after switching to aripiprazole. In patients with abnormally low prolactin levels, 48.0% of them had a rebound in psychotic symptoms, whereas in those without abnormally low prolactin levels 23.7% did so. Multivariable logistic regression analysis with adjustment for sex, early age at onset, and preswitching medications revealed that abnormally low prolactin levels were associated with psychotic rebound (adjusted odds ratio = 3.55, 95% confidence interval = 1.02, 12.5). Furthermore, there was concurrency between the trend of the cumulative proportion of patients having an abnormally low prolactin level and that of the cumulative proportion of patients having a rebound in psychotic symptoms. Conclusions An abnormally low prolactin level after switching to aripiprazole in schizophrenia patients was a potential warning sign of a psychotic rebound. Hence, monitoring of prolactin levels after switching to aripiprazole may help avoid such rebound in schizophrenia. Trial registration NCT00545467; Date of registration: 17/10/2007.

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Section: Discussionmentioning

confidence: 99%

Abnormally low prolactin levels in schizophrenia patients after switching to aripiprazole in a randomized trial: a biomarker for rebound in psychotic symptoms?

et al. 2020

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“…One such study showed that antipsychotic drug-free schizophrenic subjects exhibit a smaller increase in plasma prolactin secretion after a standard dose of the antipsychotic drug haloperidol compared to controls (Keks et al, 1987). Importantly, this decreased release of prolactin in schizophrenia was also demonstrable using a standardized dose of domperidone (Nerozzi et al, 1990), an antagonist with no CNS activity (Pourmand et al, 1980), which must therefore mediate its effects via the pituitary.…”

Section: Introductionmentioning

confidence: 94%

Measurement of dopamine D2-like receptors in postmortem CNS and pituitary: differential regional changes in schizophrenia

et al. 2004

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“…A blunted prolactin response to pharmacological challenge in schizophrenia is documented across various classes of agents—adrenergic [13], serotonergic [14, 15], and dopaminergic [16–20]. However, these results are confounded by variables such as the dose of the pharmacological challenge, the effects of treatment, age and gender, and the duration of psychosis, and negative or inverse results have also been reported.…”

Section: Challenge and Provocative Test-based Studiesmentioning

confidence: 99%

“…Negative correlations have been reported between prolactin response and inattention [28] as well as the severity of delusions [29]. Blunted prolactin responses have been associated with a “Kraepelinian” diagnosis of schizophrenia [17] and with schizophreniform disorder [20] in particular. A greater prolactin response to fenfluramine was associated with treatment resistance in one study [30].…”

Section: Challenge and Provocative Test-based Studiesmentioning

confidence: 99%

Prolactin and Psychopathology in Schizophrenia: A Literature Review and Reappraisal

Rajkumar

2014

Schizophrenia Research and Treatment

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Secretion of the anterior pituitary hormone prolactin can be significantly increased by antipsychotic drugs, leading to a range of adverse effects in patients with schizophrenia. However, there is evidence from a variety of studies that prolactin may also be related to symptom profile and treatment response in these patients, and recent work has identified variations in prolactin secretion even in drug-free patients. In this paper, a selective review of all relevant studies pertaining to prolactin and schizophrenia, including challenge and provocation studies, is presented. The implications of this work are discussed critically. A tentative model, which synthesizes these findings and argues for a significant role for prolactin in the development of schizophrenia, is outlined.

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Plasma prolactin response to domperidone in acute schizophrenia and schizophreniform illness

Cited by 8 publications

References 18 publications

Abnormally low prolactin levels in schizophrenia patients after switching to aripiprazole in a randomized trial: a biomarker for rebound in psychotic symptoms?

Abnormally low prolactin levels in schizophrenia patients after switching to aripiprazole in a randomized trial: a biomarker for rebound in psychotic symptoms?

Measurement of dopamine D2-like receptors in postmortem CNS and pituitary: differential regional changes in schizophrenia

Prolactin and Psychopathology in Schizophrenia: A Literature Review and Reappraisal

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