Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
Neuropsychiatr Dis Treat. 2014 Aug 22;10:1571-6. doi: 10.2147/NDT.S68298. eCollection 2014.
Hyperprolactinemia is a frequent consequence of treatment with antipsychotics. Earlier studies have indicated that terguride, which is a partial dopamine agonist, reduces the prolactin levels that are induced by prolactinemia. Thus, we examined the dose effects of adjunctive treatment with terguride on the plasma concentrations of prolactin in patients with elevated prolactin levels resulting from antipsychotic treatment. Terguride was concomitantly administered to 20 schizophrenic patients (10 males and 10 females) receiving paliperidone and risperidone. The dose of terguride was 1.0 mg/day. Sample collections for prolactin were conducted before terguride (baseline) and 2-4 weeks after administration. The samples were obtained after the morning dose of terguride. The average (± standard deviation) plasma prolactin concentration during terguride coadministration was significantly lower than the baseline concentration in females (82.3±37.1 ng/mL versus 56.5±28.5 ng/mL, P<0.01) but not in males (28.8±18.0 ng/mL versus 26.2±13.1 ng/mL, not significant). Additionally, a significant correlation between the ratio of prolactin reduction and the baseline prolactin concentration was identified in males (r s=-0.638, P<0.05) but not in females (r s=-0.152, not significant). Many patients complained of various adverse events following terguride administration, such as insomnia, agitation, and/or the aggravation of hallucinations. This study suggests that additional treatment with terguride decreases the prolactin concentrations in females experiencing high prolactin levels as a result of antipsychotic treatment. However, its utility for schizophrenia may be diminished because of its low tolerability.
高催乳素血症是抗精神病药物治疗的常见后果。早期研究表明,作为部分多巴胺激动剂的替格雷洛可降低催乳素血症引起的催乳素水平。因此,我们研究了替格雷洛辅助治疗对因抗精神病药物治疗而催乳素水平升高的患者的血浆催乳素浓度的剂量效应。替格雷洛与 20 名接受帕利哌酮和利培酮治疗的精神分裂症患者(10 名男性和 10 名女性)同时给药。替格雷洛的剂量为 1.0 毫克/天。在替格雷洛给药前(基线)和给药后 2-4 周采集催乳素样本。这些样本是在替格雷洛的早晨剂量后获得的。替格雷洛联合用药期间(女性:82.3±37.1ng/ml 与 56.5±28.5ng/ml,P<0.01;男性:28.8±18.0ng/ml 与 26.2±13.1ng/ml,无统计学意义)的平均(±标准差)血浆催乳素浓度明显低于基线浓度。此外,在男性中发现催乳素降低率与基线催乳素浓度之间存在显著相关性(r s=-0.638,P<0.05),而在女性中则无相关性(r s=-0.152,无统计学意义)。许多患者在替格雷洛给药后出现各种不良反应,如失眠、激越和/或幻觉加重。本研究表明,替格雷洛辅助治疗可降低因抗精神病药物治疗而催乳素水平升高的女性的催乳素浓度。然而,由于其耐受性低,其在精神分裂症中的应用可能受到限制。