Chang Gung University School of Medicine, Taoyuan, Taiwan.
Prog Neuropsychopharmacol Biol Psychiatry. 2010 Dec 1;34(8):1495-9. doi: 10.1016/j.pnpbp.2010.08.012. Epub 2010 Aug 20.
Hyperprolactinemia is associated with typical antipsychotic agents and atypical antipsychotics such as risperidone and amisulpride. This study investigates the effects of 8-week adjunctive treatment with aripiprazole in patients with hyperprolactinemia induced by risperidone in comparison to benzamide antipsychotics (amisulpride and sulpiride). Aripiprazole was administered to 24 patients with antipsychotic-induced hyperprolactinemia. The doses of pre-existing antipsychotics were fixed, while the aripiprazole dose was 5-20 mg/day during the 8-week study period. Serum prolactin levels were measured at weeks 4 and 8. Symptoms and side effects were assessed using the Positive and Negative Syndrome Scale (PANSS), Arizona Sexual Experience Scale, Abnormal Involuntary Movement Scale, Simpson-Angus Scale, Barnes Akathisia Scale, and metabolic measures at weeks 2, 4 and 8. Mean (standard error) prolactin levels decreased from 77.0±13.3 ng/mL to 18.3±2.1 ng/mL (p<0.001 vs. baseline), from 144.9±24.4 ng/mL to 127.5±21.7 ng/mL (p=0.099 vs. baseline) and 71.4±24.6 ng/mL to 43.3±14.7 ng/mL (p=0.106 vs. baseline) for those taking risperidone, amisulpride, and sulpiride, respectively. For those who took risperidone before the study started, 14 of 15 (93.3%) patients had normalized prolactin levels, while only 1 of 10 (10%) taking benzamide antipsychotics had normalized prolactin levels. The PANSS score improved significantly, and aripiprazole had no significant influence on metabolic measures or scales of movement side effects. Adjunctive aripiprazole treatment reversed effectively hyperprolactinemia induced by risperidone, but was less effective for that induced by benzamide antipsychotics.
clinicaltrials.gov Identifier: NCT00541554.
高催乳素血症与典型抗精神病药物和非典型抗精神病药物如利培酮和氨磺必利有关。本研究调查了在利培酮引起的高催乳素血症患者中，8 周辅助使用阿立哌唑的效果，与苯甲酰胺类抗精神病药物（氨磺必利和舒必利）相比。阿立哌唑被用于 24 例由抗精神病药物引起的高催乳素血症患者。在 8 周的研究期间，固定原有抗精神病药物的剂量，而阿立哌唑的剂量为 5-20mg/天。在第 4 周和第 8 周测量血清催乳素水平。使用阳性和阴性综合征量表（PANSS）、亚利桑那性体验量表、不自主运动量表、辛普森-安格斯量表、巴恩斯静坐不能量表和代谢指标在第 2、4 和 8 周评估症状和副作用。催乳素水平从 77.0±13.3ng/ml 降至 18.3±2.1ng/ml（p<0.001 与基线相比），从 144.9±24.4ng/ml 降至 127.5±21.7ng/ml（p=0.099 与基线相比）和 71.4±24.6ng/ml 降至 43.3±14.7ng/ml（p=0.106 与基线相比），分别为服用利培酮、氨磺必利和舒必利的患者。对于那些在研究开始前服用利培酮的患者，15 例中有 14 例（93.3%）催乳素水平正常，而服用苯甲酰胺类抗精神病药物的患者中只有 1 例（10%）催乳素水平正常。PANSS 评分显著改善，阿立哌唑对代谢指标或运动副作用量表无显著影响。辅助阿立哌唑治疗有效逆转了利培酮引起的高催乳素血症，但对苯甲酰胺类抗精神病药物引起的高催乳素血症效果较差。
clinicaltrials.gov 标识符：NCT00541554。
