Prevalence and risk factors of hyperprolactinemia among patients with various psychiatric diagnoses and medications

Alosaimi, Fahad D.; Fallata, Ebtihaj O.; Abalhassan, Mohammed; Alhabbad, Abdulhadi; Alzain, Nasser; Alhaddad, Bandar; Alassiry, Mohammed Z.

doi:10.1080/13651501.2018.1425459

Cited by 24 publications

(30 citation statements)

References 26 publications

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“…Some of the current patients (7.8%) underwent prolactin testing to screen for hyperprolactinaemia while on psychotropic medications. This practice is in-line with the current guidelines advocating for hyperprolactinaemia screening in such patients because of the high prevalence (44%) of hyperprolactinaemia in this setting 17,18…”

Section: Discussionsupporting

confidence: 78%

“…Recently, Alosaimi et al . reported a high prevalence of hyperprolactinaemia in psychiatric patients as well as guidelines that recommend screening for hyperprolactinaemia in such patients 18. The current institution is not a referral centre for psychiatric patients and has no inpatient psychiatric services, which may contribute to this difference.…”

Section: Discussionmentioning

confidence: 94%

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Aetiologies of Hyperprolactinaemia: A retrospective analysis from a tertiary healthcare centre

Malik

Aziz

Beshyah

et al. 2019

Sultan Qaboos Univ Med J

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Objectives: This study aimed to evaluate the aetiologies of hyperprolactinaemia in the United Arab Emirates (UAE). Methods: This retrospective study used laboratory databases to identify all patients who underwent evaluation for prolactin at Tawam Hospital, Al Ain, UAE, between 2009 and 2015. Of those 2,280 patients, all patients with low or normal prolactin (n = 1,315) were excluded. Subsequently, charts of the remaining patients (n= 965) with hyperprolactinaemia were reviewed and those with incomplete work-ups or insufficient documentation of the hyperprolactinaemia’s aetiology were excluded (n = 458). Results: A total of 507 patients were included in the study. The average age at prolactin evaluation was 36 ± 13.2 years and the majority (67.1%) of patients were female. The most common reasons for requesting prolactin were menstrual disorders (29.5%), infertility (18%),evaluation of sellar masses (14.3%), ruling out seizures (13.4 %) and monitoring while on psychiatric medications (8.7%). The most common causes of hyperprolactinaemia were prolactinoma (17%), transient hyperprolactinaemia(14.6%), drug-induced side effects (14.4%), polycystic ovarian syndrome (11.8%) and seizure disorder (7.7%). In females, common aetiologies were prolactinomas, transient and idiopathic hyperprolactinaemia, while sellar masses, seizures, chronic kidney disease and acute illnesses were common aetiologies of hyperprolactinaemia in males. The prolactin level varied between the different aetiologies and a level of >250 ng/mL was suggestive of macroprolactinoma. Conclusion: A significant proportion of patients with hyperprolactinaemia have transient hyperprolactinaemia. Before further investigations are carried out, prolactin level assessment should be repeated, especially in patients with mild hyperprolactinaemia.Keywords: Hyperprolactinemia; Prolactinoma; Etiology; Epidemiology; United Arab Emirates.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 94%

Aetiologies of Hyperprolactinaemia: A retrospective analysis from a tertiary healthcare centre

Malik

Aziz

Beshyah

et al. 2019

Sultan Qaboos Univ Med J

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“…Hormone levels were interpreted according to the standardized ranges for each test. In this study, hyperprolactinemia was defined as an increased level of prolactin above the normal laboratory levels of ≤530 mIU/L or 25 ng/mL in women, and 424 mIU/L or 20 ng/mL in men [30,31]. Subclinical hypothyroidism was defined as the absence of a palpable goiter or symptoms related to hypothyroidism from the time of subclinical hypothyroidism identification to the beginning of the study, with a TSH level (>4.5 mIU/L) and an FT4 value within normal reference values [32].…”

Section: Methodsmentioning

confidence: 99%

Prolactin and Thyroid Stimulating Hormone (TSH) Levels and Sexual Dysfunction in Patients with Schizophrenia Treated with Conventional Antipsychotic Medication: A Cross-Sectional Study

et al. 2018

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BackgroundThis study aimed to investigate the relationship between serum profiles of prolactin and thyroid stimulating hormone (TSH) and sexual dysfunction in patients with schizophrenia treated with conventional antipsychotic medication.Material/MethodsA hospital-based cross-sectional study included 118 patients, age range 18–57 years (55 men, 63 women), with a confirmed diagnosis of schizophrenia. All patients were stable after antipsychotic treatment. Serum levels of hormones, including prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone, testosterone, thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3) and free thyroxine (FT4), were detected in venous blood. The Positive and Negative Syndrome Scale (PANSS) score was used to measure symptom severity of patients with schizophrenia. The Mandarin Chinese version of the Arizona Sexual Experience Scale (ASEX), a 5-item scale, was used to measure sexual function.ResultsThere were 66 patients (55.9%) who had hyperprolactinemia, the prevalence of hyperprolactinemia was markedly higher in the sexual dysfunction group than the non-sexual dysfunction group (91.8% vs. 17.5%) (P<0.001). Mean prolactin levels were significantly increased in patients with sexual dysfunction compared with the patients without sexual dysfunction (P<0.001), with a higher incidence in female patients. Subclinical hypothyroidism and hyperprolactinemia were found to be independently associated with sexual dysfunction, and an increased PANSS negative score was an independent risk factor for the development of sexual dysfunction.ConclusionsThe incidence of sexual dysfunction was significantly increased in patients with schizophrenia. Hyperprolactinemia and subclinical hypothyroidism were associated with sexual dysfunction, especially in female patients.

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“…Spearman’s rank correlations were performed between baseline testosterone levels and demographics across all participants and with clinical characteristics and prolactin measurements in patients. Prolactin was measured to account for the prolactin-raising properties of some antipsychotic medications which can affect the HPG axis and decrease testosterone production [15, 16]. Diagnostic differences in baseline testosterone levels were determined using the Mann-Whitney U test in males and using Quade’s rank analysis of covariance in females (with age as a covariate) as baseline testosterone levels significantly correlated with age in females (ρ = –0.25, p = 0.03).…”

Section: Methodsmentioning

confidence: 99%

“…Together, these studies suggest that a deficit in circulating testosterone or brain response to testosterone may relate to functional impairments in males with schizophrenia. Some antipsychotic medications can cause hyperprolactinemia, which can alter feedback mechanisms within the hypothalamic-pituitary-gonadal (HPG) axis and decrease testosterone production [15, 16]; however, hyperprolactinemia has also been found in antipsychotic-naive patients and suggests HPG axis dysfunction in people with schizophrenia [17, 18]. …”

Section: Introductionmentioning

confidence: 99%

Sex-Specific Associations of Androgen Receptor CAG Trinucleotide Repeat Length and of Raloxifene Treatment with Testosterone Levels and Perceived Stress in Schizophrenia

et al. 2018

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Lower testosterone levels are associated with greater negative symptoms in men with schizophrenia. Testosterone signals via androgen receptor (AR). A functional variant in the AR gene (CAG trinucleotide repeat polymorphism) is associated with circulating testosterone and mood-related symptoms in healthy people. Raloxifene increases testosterone in healthy males and reduces symptom severity and improves cognition in schizophrenia; however, whether raloxifene increases testosterone in men with schizophrenia is unknown. We assessed the interaction of a functional AR gene variant and adjunctive raloxifene on peripheral testosterone and symptom severity in schizophrenia. Patients with schizophrenia (59 males and 38 females) participated in a randomized, double-blind, placebo-controlled, crossover trial of adjunctive raloxifene (120 mg/day). Healthy adults (46 males and 41 females) were used for baseline comparison. Baseline circulating testosterone was decreased in male patients compared to male controls and positively correlated with CAG repeat length in male controls and female patients. Male patients with short, compared to long, CAG repeat length had higher stress scores. Raloxifene treatment increased testosterone in male patients, but was unrelated to AR CAG repeat length, suggesting that raloxifene’s effects may not depend on AR activity. Sex-specific alterations of the relationship between AR CAG repeat length and testosterone suggest that altered AR activity may impact perceived stress in men with schizophrenia.

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Prevalence and risk factors of hyperprolactinemia among patients with various psychiatric diagnoses and medications

Cited by 24 publications

References 26 publications

Aetiologies of Hyperprolactinaemia: A retrospective analysis from a tertiary healthcare centre

Aetiologies of Hyperprolactinaemia: A retrospective analysis from a tertiary healthcare centre

Prolactin and Thyroid Stimulating Hormone (TSH) Levels and Sexual Dysfunction in Patients with Schizophrenia Treated with Conventional Antipsychotic Medication: A Cross-Sectional Study

Sex-Specific Associations of Androgen Receptor CAG Trinucleotide Repeat Length and of Raloxifene Treatment with Testosterone Levels and Perceived Stress in Schizophrenia

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