Lambert Tammy L, Farmer Kevin C, Brahm Nancy C
Department of Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma, Oklahoma City, USA.
Int J Endocrinol Metab. 2013 Winter;11(1):57-61. doi: 10.5812/ijem.4366. Epub 2012 Dec 21.
Patients with intellectual disabilities may be treated with antipsychotic medications for a variety of diagnoses. Use of this category of medication can increase prolactin levels and place the patient at risk for sexual dysfunction and lower bone mineral density. The proposed mechanism of action is affinity for the dopamine receptor. Use of bromocriptine, a dopamine receptor antagonist, was proposed to attenuate hyperprolactinemia.
The objectives of this study were to (1) review serum prolactin (PRL) elevations associated with the use of antipsychotic (AP) medications in an intellectually disabled adult population and (2) determine if any association existed between the level of elevation and AP used.
Medical records for adult patients at two Oklahoma facilities for the intellectually disabled were reviewed to evaluate prolactin levels for individuals prescribed antipsychotics. A linear regression model was used to evaluate the relationship between prolactin levels with intellectual disability level, bromocriptine use, demographics, and antipsychotic.
73 (n = 53 males, n = 20 females) patients met criteria. The average age was 41.2 years. Nearly 70% of the patients had severe to profound levels of disability. 77% were prescribed second generation antipsychotics; 19% received first generation agents. Two variables, gender and bromocriptine use, were found to be significant predictors of prolactin levels. Mean prolactin level for females was 44 ng/mL (normal range: 4-30 ng/mL, males = 4-23 ng/mL). Patients who did not receive bromocriptine had mean levels of 23 ng/mL. No significant difference in prolactin levels was found for type of AP.
Mean prolactin levels for females were significantly higher than for males. Both sexes were found to have higher-than-normal levels. Use of bromocriptine was associated with higher prolactin levels. In this population of patients, the type of AP used had no significance on prolactin levels.
智障患者可能因多种诊断而接受抗精神病药物治疗。使用这类药物会使催乳素水平升高，使患者面临性功能障碍和骨矿物质密度降低的风险。其作用机制被认为是对多巴胺受体具有亲和力。有人提出使用多巴胺受体拮抗剂溴隐亭来减轻高催乳素血症。
本研究的目的是：（1）回顾智障成年人群中与使用抗精神病药物相关的血清催乳素（PRL）升高情况；（2）确定升高水平与所使用的抗精神病药物之间是否存在关联。
回顾了俄克拉荷马州两家智障患者机构中成年患者的病历，以评估服用抗精神病药物患者的催乳素水平。采用线性回归模型评估催乳素水平与智障程度、溴隐亭使用情况、人口统计学特征及抗精神病药物之间的关系。
73名患者（53名男性，20名女性）符合标准。平均年龄为41.2岁。近70%的患者有重度至极重度残疾。77%的患者服用第二代抗精神病药物；19%的患者服用第一代药物。发现性别和溴隐亭使用情况这两个变量是催乳素水平的显著预测因素。女性的平均催乳素水平为44纳克/毫升（正常范围：4 - 30纳克/毫升，男性为4 - 23纳克/毫升）。未服用溴隐亭的患者平均水平为23纳克/毫升。抗精神病药物类型与催乳素水平无显著差异。
女性的平均催乳素水平显著高于男性。发现两性的催乳素水平均高于正常。使用溴隐亭与较高的催乳素水平相关。在这群患者中，所使用的抗精神病药物类型对催乳素水平无影响。
