Safety of Cabergoline in the Management of Pituitary Prolactin-Induced Symptoms with Patients Treated with Atypical Neuroleptics

Coronas, Ramón; Cobo, Jesús; Giménez-Palop, Olga; Ortega, Emilio; Márquez, María Dolores Benítez

doi:10.2174/157488612802715753

Cited by 13 publications

(4 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In case reports and series, bromocriptine, cabergoline, and pramipexole have decreased prolactin levels. 31 - 36 Several patients also experienced resolution of symptoms, such as amenorrhea, 33 - 35 galactorrhea, 31 , 33 , 34 and sexual dysfunction. 32 There have been a few reports on patients who had experienced an exacerbation of psychosis after initiation of a dopamine agonist.…”

Section: Methodsmentioning

confidence: 98%

Management of antipsychotic-induced hyperprolactinemia

Tewksbury

Olander

2016

Mental Health Clinician

View full text Add to dashboard Cite

Introduction:Antipsychotics represent a large portion of the psychotropics that may induce hyperprolactinemia. Clinical psychiatric pharmacists must be adept in stratifying the relative risk of hyperprolactinemia among psychotropics, identifying patient risk factors, recognizing differential diagnoses, and recommending therapeutic alternatives and treatment strategies. High-potency, typical antipsychotics are more likely to elevate prolactin although exceptions to the rule exist.Methods:A literature search of PubMed and Google Scholar was performed to identify English language articles on the treatment of antipsychotic-induced hyperprolactinemia in humans. Methodological rigor is summarized for compiled studies in addition to feasibility and limitations of application to clinical practice.Results:There is an absence of robust evidence for the management of antipsychotic-induced hyperprolactinemia. Among the pharmacological treatments studied, aripiprazole (switching or augmentation) possessed the strongest evidence. Pharmacological treatments with less evidence encompassed dose reduction, switching to lower potency antipsychotics, and adding dopamine agonists. To date, no head-to-head studies have been published on the above approaches.Discussion:Atypical antipsychotics with low affinity for dopamine (D2) receptors, such as olanzapine, are logical alternatives for the patient experiencing drug-induced hyperprolactinemia. When augmentation is clinically preferred to switching, a viable option is the addition of a full or partial dopamine agonist, such as bromocriptine or aripiprazole, respectively. Patient-specific risk of psychiatric decompensation and the severity of symptomatic hyperprolactinemia should be weighed when formulating treatment strategies.

show abstract

Section: Methodsmentioning

confidence: 98%

Management of antipsychotic-induced hyperprolactinemia

Tewksbury

Olander

2016

Mental Health Clinician

View full text Add to dashboard Cite

show abstract

“…Лекарственная гиперпролактинемия может протекать бессимптомно или сопровождаться рядом клинических проявлений: гипогонадизмом (за счет подавления секреции гонадотропин-рилизинг-гормона и снижения чувствительности рецепторов гипофиза к нему, как следствие -снижения уровней лютеинизирующего, фолликулостимулирующего гормонов), проявляющимся нарушением менструального цикла -олигоменореей, аменореей -у женщин, бесплодием; галактореей, гинекомастией и остеопорозом [5,15,43] (вследствие повышения активности остеокластов на фоне активизации в остеобластах цитокинов и снижения уровня мРНК остеопротегерина, ингибирования пролиферации остеобластов) [1].…”

Section: клинические симптомыunclassified

“…При этом перед началом терапии рекомендовано подробно изучить исходную психосексуальную функцию и регулярность менструального цикла у женщин [44][45][46]. Проведение предварительного скрининга позволяет в дальнейшем разрешить вопрос дифференцировки возможных причин гиперпролактинемии и способствует выбору оптимального диагностического пути и методов лечения [43,47].…”

Section: диагностикаunclassified

Drug-induced hyperprolactinemia: mechanism of development, features of diagnosis and treatment

Dzeranova,

Vorotnikova,

Shutova

et al. 2023

Obes. metabol.

View full text Add to dashboard Cite

One of the causes of non-tumor related hyperprolactinemia is taking a medications. Physicians of various specialties, such as cardiologists, gastroenterologists, endocrinologists, and neurologists, encounter hyperprolactinemia as a side effect of drug therapy in their practice, but it is most often observed in the practice of a psychiatrist when treating patients with psychotropic medications. Over the past few years, there has been an increase in the frequency of prescriptions of antidepressants and neuroleptics due to post-COVID-19 syndrome, anxiety and stress caused by the pandemic of a new coronavirus infection. There is also a predisposition to the development of hyperprolactinemia on the background of taking neuroleptics due to genetic features of patients. Currently, there is no established common algorithm for diagnosis and treatment of drug-induced hyperprolactinemia in the world. Based on a review of foreign and domestic literature, the article discusses in detail the mechanisms of development and various approaches to the correction of iatrogenic (drug-induced) hyperprolactinemia, assesses the prolactogenic activity of neuroleptics, and proposes algorithms for prolactin monitoring and correction of hyperprolactinemia using dopamine agonists. Often the tactics of management of such patients need to be discussed by a team of specialized physicians.

show abstract

“…However, bromocriptine has been used without major problems (22). There is evidence to suggest that cabergoline can be used safely in patients with antipsychotic medication without exacerbating the psychotic symptoms and without having any alteration in antipsychotic effects of these medications (35). However, it is advisable to use these drugs with extreme caution with the close consultation of a psychiatrist only in patients (36, 37).…”

Section: Dopamine Agonists Therapymentioning

confidence: 99%