Prolactin variations during risperidone therapy in a sample of drug-naive children and adolescents

Abstract

The aim of this prospective observational study was to investigate the variations of serum prolactin hormone (PRL) in a sample of 34 drug-naive patients (mean age 13 years) who started risperidone therapy assuming that several factors may favor the increase in serum PRL. Serum PRL and hyperprolactinemia clinical signs were examined at baseline (T0) and after almost 3 months of treatment (T1). We considered sex, pubertal status, risperidone dosage, psychiatric diagnosis, and any personal/family history of autoimmune diseases. The mean serum PRL value increased between T0 and T1 (P=0.004). The mean serum PRL was higher in females in the pubertal/postpubertal stage and for risperidone dosage up 1 mg/day. Hyperprolactinemia was found in 20% of patients at T0 and in 38% of patients at T1 (P=0.03). The mean serum PRL increase was greater in early-onset schizophrenia spectrum psychosis patients compared with no-early-onset schizophrenia spectrum psychosis patients (P=0.04). The increase in PRL was higher in patients with a personal and a family history of autoimmune diseases. This study suggests that the increase in serum PRL in patients treated with risperidone may be linked not only to the drug and its dosage but also to several risk factors such as sex, pubertal stage, psychiatric disease, and autoimmune disorders.

Prolactin related symptoms during risperidone maintenance treatment: results from a prospective, multicenter study of schizophrenia

“…We did not identify an association between PRS and age; however, a negative association was identified between PRS and age at onset. Similarly, it has been demonstrated that the mean plasma prolactin level was increased in early-onset schizophrenia spectrum psychosis patients compared with no-early-onset patients [32]. Another finding of this study is that the risperidone dose was positively associated with the severity of PRS, which is consistent with the previous study.…”

9‐Hydroxyrisperidone‐Induced Hyperprolactinaemia in Thai Children and Adolescents with Autism Spectrum Disorder

“…Thirdly, this study did not have any data of describing serum prolactin level of the patients before receiving risperidone treatment. To account for this limitation, age-and genderappropriate reference ranges [16] were used to define hyperprolactinaemia. Lastly, this study did not comment on whether patients had symptoms (such as amenorrhoea or others mentioned above) as a result of the increase; it only reported that in the laboratory, prolactin levels were increased in the patients' blood.…”

“…Another study [16] revealed that the increase in serum prolactin may be linked to other factors, such as the drug and its dosage, sex, pubertal stage and psychiatric disease. Our previous study [15] revealed an association between prolactin level and risperidone dosage.…”

“…Elevation of prolactin concentration corresponds to dopamine D2 receptor blockade [9,10]. Most studies report that children and adolescents treated with risperidone have 38-50% incidence of hyperprolactinaemia [4,[11][12][13][14][15][16].Early studies reported adverse effects associated with prolactin elevation because hyperprolactinaemia is one of the most common endocrinological disorders of the hypothalamic-pituitary axis [8]. Hyperprolactinaemia in female patients can result in amenorrhoea, galactorrhoea, anovulation and irregular menses, and in male patients, it can lead to azoospermia, impotence, gynaecomastia and galactorrhoea [17].…”

“…Elevation of prolactin concentration corresponds to dopamine D2 receptor blockade [9,10]. Most studies report that children and adolescents treated with risperidone have 38-50% incidence of hyperprolactinaemia [4,[11][12][13][14][15][16].…”